动脉瘤性蛛网膜下腔出血患者垂体激素和甲状腺激素变化的临床研究

发布时间：2018-08-14 14:25

【摘要】：目的通过对动脉瘤性蛛网膜下腔出血患者垂体激素（ACTH、TSH、FSH、PRL、 GH、 LH）和甲状腺激素(T3、 T4、 FT3、 FT4)含量变化的观察，探讨各激素含量变化与病情轻重、出血量及预后的关系。临床资料与方法以42例颅内动脉瘤破裂患者为研究对象，出血量按Fisher CT分级，病情轻重按Hunt-Hess分级，预后按死亡与否分组。全部42例患者均在急性期(发病后1-3天)抽血，均送往我院核医学科及检验中心进行集中检测。结果①各指标与病情轻重的关系：Hunt分级I、II级患者各指标（ACTH、TSH、FSH、PRL、GH、LH、T3、FT3）与对照组相比无显著性差异，P0.05；Hunt分级III级、 IV-V级患者与对照组相比有显著性差异，， P＜0.05；各激素水平随Hunt分级升高而升高，I级、II级虽升高，但无统计学意义；T4、 FT4水平不随Hunt分级变化而变化，与对照组相比无显著差异性，P0.05。②各指标与出血量的关系：Fisher CT分级I、II级患者各指标（ACTH、TSH、FSH、PRL、 GH、 LH、 T3、 FT3）与对照组相比无显著性差异， P0.05； III级、 IV级患者与对照组相比有显著性差异，P＜0.05；T4、 FT4水平不随Fisher CT分级变化而变化，与对照组相比无显著差异性，P0.05。③各指标（ACTH、TSH、FSH、PRL、GH、LH）在死亡组与存活组之间比较差异有显著性P＜0.05；各部位动脉瘤之间比较，各指标差异无显著性，P0.05。结论颅内动脉瘤破裂出血患者急性期各激素（ACTH、TSH、FSH、PRL、GH、 LH、 T3、 FT3）指标的升高与出血量、病情轻重、预后呈正相关。出血量越多，病情越重，预后越差各指标升高越明显。T4、FT4含量变化与病情轻重及出血量无关联。说明各垂体激素及T3、FT3的变化在一定程度上反映了下丘脑-垂体功能的受损程度，可用来评估病情及判断预后。
[Abstract]:Objective to observe the changes of pituitary hormone (GH, LH) and thyroid hormone (T _ 3, T _ 4, FT _ 3, FT4) in patients with aneurysm subarachnoid hemorrhage (SAH), and to explore the relationship between the changes of these hormones and the severity of the disease, the amount of bleeding and the prognosis. Methods 42 patients with ruptured intracranial aneurysms were studied. The amount of bleeding was classified according to Fisher CT, the severity of the disease was classified by Hunt-Hess, and the prognosis was classified by death or not. All 42 patients were taken blood in acute phase (1-3 days after onset) and were sent to our nuclear medicine department and laboratory for centralized examination. Results (1) the relationship between each index and the severity of the disease was not significantly different from that of the control group (P < 0.05), and there was a significant difference between the two groups (P < 0.05). There was a significant difference between the IV-V grade and the control group (P < 0.05), and there was no significant difference between the two groups (P < 0.05). The levels of each hormone increased with the increase of Hunt grade, but there was no significant difference between T4 and T4. The level of FT4 did not change with Hunt grade. There was no significant difference between the two groups. There was no significant difference between the two groups (P0.05.2). There was no significant difference between the two groups (P0.05), and there was no significant difference between the two groups (P0.05). There was significant difference between the III grade and the IV grade patients and the control group (P < 0.05). The FT4 level did not change with the Fisher CT grade. There was no significant difference (P < 0.05) between death group and survival group (P < 0.05). Conclusion the elevation of FT3, LH, T3, FT3 in patients with ruptured intracranial aneurysms at acute stage is positively correlated with the amount of bleeding, the severity of the disease and the prognosis. The higher the amount of bleeding, the more serious the condition, the worse the prognosis. The higher the prognosis, the more obvious the change of FT4 content in T4 was not related to the severity of the disease and the amount of bleeding. The results showed that the changes of pituitary hormones and T _ 3T _ 3FT _ 3 reflected the degree of hypothalamus-pituitary function damage to some extent, and could be used to evaluate the condition of the disease and to judge the prognosis.
【学位授予单位】：宁夏医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R743.35

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