中枢性甲状腺功能减退的病因及临床特点分析

Etiological Factors of Central Hypothyroidism

目的探讨中枢性甲状腺功能减退(CH)的病因。方法选取77例CH患者,逐一记录患者所出现的各种临床表现及实验室检查结果,分析CH的病因。结果下丘脑-垂体处(鞍上或鞍区)占位性病变占70.1%(54/77),鞍区手术和放疗损伤占24.7%(19/77),Sheehan综合征是女性CH患者主要的发病原因(14/35,占40.0%)。多数患者除有甲状腺功能减退症状外,尚有原发疾病的表现或有继发性性腺、肾上腺皮质功能低下的表现。结论下丘脑-垂体处占位性病变是本病最多见的病因,其次是鞍区手术和放疗损伤;Sheehan综合征是女性CH最多见的病因。

Objective To investigate the causes of central hypothyroidism（CH）.Methods Record variety of clinical symptoms,and laboratory tests of 77 patients with CH,then analyze the causes of CH.Results About 70.1%（54/77） of these cases were caused by Hypothalamus-pituitary mass lesions,24.7%（19/77） by surgery and radiation therapy.Most patients not only had performances of hypothyroidism symptoms,but the performances of primary disease or secondary gonadal,adrenal insufficiency symptoms.Conclusion Hypothalamus-pituitary mass lesions were the most common cause of CH,followed by surgery and radiation therapy,and Sheehan syndrome were more common in females.