减重手术患者术前垂体核磁检查及相关激素水平分析

Analysis of preoperative pituitary MRI and related hormone levels in patients with bariatric surgery

目的通过分析垂体相关激素水平来探讨垂体核磁共振检查对拟行减重手术患者评估垂体功能和指导手术治疗的临床意义,以及垂体核磁共振检查对减重患者的适用范围。方法回顾性分析2020年1月至2021年9月天津医科大学总医院内分泌科收治的138例拟行减重手术患者的临床资料,根据其垂体核磁共振检查是否发现异常信号、异常结构将其分为垂体核磁结果阳性组和阴性组。阳性组93人,阴性组45人。对两组研究对象的垂体相关激素(包括垂体产生以及垂体激素刺激靶腺器官产生的激素)以及治疗方面进行描述和差异性、相关性分析。结果垂体核磁阳性组和阴性组垂体激素水平比较无统计学差异(P>0.05),垂体核磁阳性组和阴性组与是否行减重手术无相关性(P>0.05)。结论对于病史、临床特征、实验室检查高度怀疑垂体疾病的患者应行垂体核磁增强检查以明确诊断;但对于拟行减重手术的患者,不建议将垂体核磁成为常规的术前检查。

Objective To explore the clinical significance of pituitary MRI in evaluating pituitary function and guiding surgical treatment in patients undergoing bariatric surgery,and the scope of application of pituitary MRI in patients undergoing bariatric surgery by analyzing the levels of pituitary-related hormones.Methods We evaluated 138 patients with planned bariatric surgery who were admitted to the Department of Endocrinology and Metabolism of Tianjin Medical University General Hospital between January 2020 and September 2021.According to whether abnormal signal and structure were found in pituitary MRI examination,they were divided into positive group and negative group.There were 93 in positive group and 45 in negative group.Pituitary-related hormones(including pituitary production and hormones produced by pituitary hormone stimulation to target gland organs)and treatment of the two groups of subjects were described and the differences were analyzed.Results There was no significant difference in pituitary hormone levels between the positive and negative pituitary MRI groups,indicating that there was no significant difference in pituitary function between the positive and negative pituitary MRI groups.χ2 test was performed on whether bariatric surgery was performed in the pituitary MRI negative group and positive group,and the results were P>0.05,pituitary MRI results had no effect on the bariatric surgery.Conclusions For patients with highly suspected pituitary diseases in the history,clinical manifestations and laboratory examination,pituitary MRI should be performed to confirm the diagnosis.However,pituitary MRI is not recommended as a routine preoperative examination for patients with bariatric surgery.