儿童甲状腺功能减低并发垂体增生8例报告

目的：探讨甲状腺功能减低致垂体增生的内分泌激素的改变及治疗效果。方法：回顾性分析8例甲状腺功能减低致垂体增生儿童（3例男性，5例女性，年龄5～9岁）的临床资料,治疗随访1～6年。结果：8例患儿的甲状腺激素水平均降低，促甲状腺素（TSH）及血浆泌乳素（PRL）水平增高，予以甲状腺素替代治疗，用药2～6月后，血清游离三碘甲腺原氨酸(FT3)、游离四碘甲腺原氨酸(FT4)、TSH及PRL恢复正常,垂体体积恢复正常大小。其中6 例身高增长由治疗前3.1±0.5 cm/年，提高到治疗后11.6±1.7 cm/年，差异有显著性(P<0.01)。另外2例儿童甲状腺素替代治疗后身高增长不理想，予以基因重组人生长激素（rhGH）治疗后，随访身高增长为11 cm/年。8例均无垂体增生复发。结论：对于身材矮小儿童进行甲状腺功能及垂体检查十分必要，甲状腺素替代治疗是儿童甲状腺功能减低致垂体增生的有效手段。在垂体增生恢复后仍然合并生长激素缺乏的患儿予以生长素治疗可以获得满意的身高增长。［中国当代儿科杂志，2010，12（1）：17-20］

Pituitary hyperplasia secondary to primary hypothyroidism in children: report of 8 cases

Objective To study the changes in hormone levels and the therapy of pituitary hyperplasia secondary to primary hypothyroidism in children.Methods The clinical data of 8 children with pituitary hyperplasia secondary to primary hypothyroidism (5 girls and 3 boys) at ages of 5 to 9 years were studied retrospectively.All of the children had a short stature.They were followed up 1 to 6 years.Results The thyroid hormone levels decreased and the serum thyroid stimulating hormone (TSH) and prolactin (PRL) levels in...