重症颅脑损伤后血清垂体前叶激素的变化及相关因素分析

doi:10.3760/cma.j.issn.1674-6090.2017.06.014

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题名	重症颅脑损伤后血清垂体前叶激素的变化及相关因素分析
其他题名	Changes of blood anterior pituitary hormone and its related factors in patients with severe traumatic brain injury
作者	徐洪波; 程水兵; 谢先海; 赵峰; 吴广宇
发表日期	2017-12-25
发表期刊	中华内分泌外科杂志影响因子和分区
语种	中文
原始文献类型	学术期刊
关键词	创伤性颅脑损伤垂体激素
其他关键词	Traumatic brain injury ; Pituitary ; Hormone
摘要	目的探讨重症创伤性颅脑损伤(traumatic brain injury,TBI)后血清垂体前叶激素的变化及相关因素。方法回顾性分析2010年6月至2015年8月在温州医科大学附属第一医院创伤外科住院治疗的113例重症TBI患者的临床资料,包括年龄、性别、损伤部位、是否合并硬膜外血肿、是否合并硬膜下血肿、是否伴有颅底骨折、受伤时间、Glasgow昏迷评分(glasgow coma scale,GCS评分)、中线移位程度、是否合并弥漫性轴索损伤、是否合并脑疝、是否合并外伤性蛛网膜下腔出血等;采用单因素x~2检验和多因素Logistic回归分析探究垂体前叶激素异常的危险因素。结果 48例出现垂体前叶激素分泌异常,其中1种激素分泌异常者10例;2种及2种以上激素分泌异常者38例;生长激素(GH)水平异常降低20例、促甲状腺激素(TSH)水平异常降低18例、促卵泡激素(FSH)水平异常降低12例、催乳素(PRL)水平异常增高10例、促肾上腺皮质激素(ACTH)水平异常降低9例、黄体生成素(LH)水平异常降低8例。单因素x~2检验提示是否合并颅底骨折(P=0.006)、中线移位程度(P=0.007)、GCS评分(P=0.004)、是否合并弥漫性轴索损伤(P=0.001)、是否合并脑疝(P=0.001)、是否合并外伤性蛛网膜下腔出血(P=0.001)是垂体前叶激素分泌异常的相关因素。多因素Logistic回归分析显示颅底骨折(P=0.019)、中线移位>1 cm(P=0.015)、GCS评分(P=0.024)、弥漫性轴索损伤(P=0.008)、脑疝(P=0.001)、外伤性蛛网膜下腔出血(P=0.010)是垂体前叶激素分泌异常的危险因素。结论重症TBI患者远期并发垂体前叶激素异常风险较高,其中颅底骨折、中线移位>1 cm、GCS评分、弥漫性轴索损伤、脑疝、外伤性蛛网膜下腔出血是垂体前叶激素分泌异常的危险因素。
其他摘要	Objective To explore changes of blood anterior pituitary hormone and its related factors in patients with severe traumatic brain injury (TBI).Methods 113 patients diagnosed as severe TBI and met criterions were collected from Jun.2010 to Aug.2015 in the First Affiliated Hospital of Wenzhou Medical University.Clinical data such as age,gender,site of injury,epidural hematoma,subdural hematoma,basicranial fracture,injury time,Glasgow coma scale (GCS),middle line migration,diffuse axonal injury,brain hernia,traumatic subarachnoid hemorrhage were collected and recorded.Univariatex2 test and multivariate logistic regression analysis were used to explore risk factors for changes of blood anterior pituitary hormone.Results Abnormal secretion of the anterior pituitary occurred in 48 patients.10 cases had one kind of abnormal hormone secretion,while 38 cases had 2 and more than 2 kinds of abnormal hormone secretion.GH level decreased in 20 cases,TSH level decreased in 18 cases,FSH level decreased in 12 cases,PRL level increased in 10 cases,ACTH level decreased in 9 cases,and LH level decreased in 8 cases.Univariate x2 test revealed that basicranial fracture (P=0.006),middle line migration (P=0.007),GCS score (P=0.004),diffuse axonal injury (P=0.001),cerebral hernia (P=0.001),traumatic subarachnoid hemorrhage (P=0.001) were factors related to abnormal pituitary hormone levels.Multivariate logistic regression analysis revealed that basicranial fracture (P=0.019),middle line migration (P=0.015),GCS score (P=0.024),diffuse axonal injury (P=0.008),cerebral hernia (P=0.001),traumatic subarachnoid (P=0.010) were factors related to abnormal pituitary hormone levels.Conclusions The rates of abnormal pituitary hormone level were higher in patients with severe TBI.The basicranial fracture,middle line migration,GCS score,diffuse axonal injury,cerebral hernia,traumatic subarachnoid hemorrhage are factors related to abnormal pituitary hormone levels.
资助项目	浙江省自然科学基金（LY16H090015）~~
ISSN	1674-6090
卷号	11 期号:06 页码:500-503+508
DOI	10.3760/cma.j.issn.1674-6090.2017.06.014
页数	5
收录类别	CNKI ; 万方 ; 维普 ; ISTIC
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引用统计
文献类型	期刊论文
条目标识符	https://kms.wmu.edu.cn/handle/3ETUA0LF/38691
专题	附属第一医院_创伤外科（急诊外科）
作者单位	浙江省温州医科大学附属第一医院创伤外科
第一作者单位	附属第一医院_创伤外科（急诊外科）
第一作者的第一单位	附属第一医院_创伤外科（急诊外科）
推荐引用方式 GB/T 7714	徐洪波,程水兵,谢先海,等. 重症颅脑损伤后血清垂体前叶激素的变化及相关因素分析[J]. 中华内分泌外科杂志,2017,11(06):500-503+508.
APA	徐洪波, 程水兵, 谢先海, 赵峰, & 吴广宇. (2017). 重症颅脑损伤后血清垂体前叶激素的变化及相关因素分析. 中华内分泌外科杂志, 11(06), 500-503+508.
MLA	徐洪波,et al."重症颅脑损伤后血清垂体前叶激素的变化及相关因素分析".中华内分泌外科杂志 11.06(2017):500-503+508.