中枢性尿崩症患者病因分布及临床特点分析

Analysis of Etiological distribution and clinical characteristics of central diabetes insipidus

目的分析中枢性尿崩症患者病因分布及临床特点。方法选择荥阳市人民医院2016年1月—2019年1月期间内分泌科收治的120例中枢性尿崩症患者,根据患者病因构成分为特发性组(n=75)和继发性组(n=45),对比不同年龄,病因患者的临床表现以及垂体前叶功能检查结果,分析不同类型中枢性尿崩症患者的临床特点以及特性发中枢性尿崩症的特点。结果未成年患者年龄主要为12~16岁,成年患者年龄主要为35~45岁;成年患者的特发性中枢性尿崩症发生率(81.43%)显著高于未成年患者(36.00%),鞍区肿瘤所致中枢性尿崩症患者比例(4.29%)低于未成年患者(26.00%),组间数据对比有统计学意义(χ2=25.6823、11.9011,P<0.05);继发性组在头痛,视力下降,肾上腺轴,性腺轴以及甲状腺轴异常方面发生率分别为8.88%、20.00%、33.33%、46.66%及35.55%,均显著高于特发性组,特发组发生率分别为0.00%、2.66%、4.00%、8.00%、5.33%。组间数据对比有统计学意义(χ2=18.181、10.148、18.980、24.114、18.496,P<0.05)。结论特发性属于中枢性尿崩症患者的主要病因,特发性以及继发性中枢性尿崩症在垂体功能异常率,以及临床表现方面存在着较大的差异,临床可结合影像学检查结果,患者临床特征以及垂体功能检查结果对患者进行进一步对诊断。

Objective To analyze the etiological distribution and clinical characteristics of central diabetes insipidus.Methods Selection in our hospital between January 2016 and January 2019 endocrinologist admitted during the period of 120 patients with central diabetes insipidus,according to the divided into etiology in patients with idiopathic group(n=75)and secondary(n=45)and comparison of different ages,causes the patient’s clinical symptoms and pituitary function test results,analysis the clinical characteristics of patients with different types of central diabetes insipidus and characteristic features of central diabetes insipidus.Results The age of juvenile patients was mainly 12~16 years old,while that of adult patients was 35~45 years old.The incidence of idiopathic central diabetes insipidus in adult patients(81.43%)was significantly higher than that in adolescent patients(36.00%),and the proportion of patients with central diabetes insipidus caused by tumors in saddle area(4.29%)was lower than that in adolescent patients(26.00%),with statistically significant difference(χ2=25.6823,11.9011,P<0.05).The incidence of headache,vision loss,adrenal axis,gonad axis and thyroid axis abnormalities in the secondary group were 8.88%,20.00%,33.33%,46.66%and 35.55%,respectively,which were significantly higher than those in the idiopathic group,with the incidence of 0.00%,2.66%,4.00%,8.00%and 5.33%,respectively.The data between the two groups were statistically significant(χ2=18.181,10.148,18.980,24.114,18.496,P<0.05).Conclusion Idiopathic diabetes is the main cause of central diabetes insipidus.There are great differences between idiopathic diabetes insipidus and secondary diabetes insipidus in the rate of pituitary dysfunction and clinical manifestations.The clinical diagnosis can be further made by combining the results of imaging examination,the clinical characteristics of patients and the results of pituitary function examination.