多发性脑梗死垂体腺轴功能关系的研究

Study on the Relationship Between the Function of Pituitary-Adrenal Axis and Multiple Cerebral Infarction

目的通过对多发性脑梗死(MCI)患者垂体-甲状腺轴与垂体-肾上腺轴相关激素水平的检测,探讨MCI与垂体-甲状腺轴与垂体-肾上腺轴功能的关系。方法采用化学发光免疫分析法或放射免疫分析法检测28例不伴痴呆的多发性脑梗死(MCI)及23例同龄健康对照组的血清皮质醇、ACTH、TT3、TT4、TSH、FT3、FT4水平,部分MCI患者进行过夜1mg地塞米松抑制试验。结果①血清皮质醇、ACTH水平MCI组与对照组相比统计学均无显著差异;部分地塞米松抑制试验显示,MCI组患者均被抑制。②血清TT3,FT3,FT4水平MCI组显著低于对照组,而血清TT4,TSH值MCI组与对照组相比无差异。结论多发性脑梗死患者垂体-肾上腺素皮质轴功能正常,但甲状腺功能有明显异常。

Objective To investigate the relationship between multiple cerebral infarction and the function of pituitary- adrenal axis and pituitary- hypothyroid axis. Methods Serum levels of cortisol, adrenocorticotropic hormone（ACTH）, triiodothyronine（T3 ）, thyroxine（T4 ）, free T3 （FT3）, free T4 （FT4）, and thyroid stimulating hormone（TSH） were determined by automated chemiluminescent immunoassay system or radioimmunoassay in 28 cases with multiple cerebral - infarction （MCI） and 23 normal individuals. A dexamethasone suppression test （DST） was performed in some patients with MCI. Results ① No significant differences were found in serum cortisol and ACTH between MCI and healthy controls. DST revealed that serum cortisol and ACTH in MCI patients were repressed. ② The serum T3, FT3 and FT4 levels in cases with MCI were lower than that in the control group. No significant difference was found in serum T4 and TSH between the two groups. Conclusions The functional state of pituitary - adrenal axis in cases with MCI is normal, but the serum thyroid is abnormal obviously.