高海拔地区颅脑损伤后性腺激素改变的临床研究

Clinical study of sex hormones after traumatic brain injury in high altitude

目的探讨高海拔地区急性颅脑损伤患者性腺激素的改变及其临床意义。方法选取119例急性颅脑损伤患者。伤后第1、14和28天采集静脉血,采用放射免疫法测定血清促黄体生成素（LH）、卵泡刺激素（FSH）、泌乳素（PR L）、睾酮（T）、孕酮（P）及雌二醇（E2）水平。根据入院时GCS评分将119例患者分为轻型损伤组、中型损伤组和重型损伤组。本组患者伤后28 d病死率为10.9%。根据伤后28 d GOS评分将106例患者分为1~2分组、3~4分组和5分组。选取门诊体检健康人群作为对照组。结果伤后血清T、E2水平下降,而PR L、LH、FSH血清水平上升。生活在海拔3 km以上者性腺激素水平改变的发生率更高。结论颅脑损伤患者存在不同程度的性腺激素分泌异常,监测颅脑损伤患者性腺激素水平及其动态变化有助于病情评估及预后判断。海拔高度是影响颅脑损伤后性腺激素改变的重要因素。

【Objective】 To discuss the changes of gonadal hormone and its clinical significance in high altitude areas after acute brain injury.【Method】 119 patients with acute brain injury patients were enrolled.Serum samples were collected in days 1,14 and 28 after injury.The serum LH,FSH,PRL,T,P and E2 levels were measured by radioimmunoassay.According to GCS score on admission,119 patients were divided into light injury group,medium group and the severe injury group.28d after injured,the mortality rate of this group was 10.9%.Based on GOS score,106 patients were grouped into 1～2group,3～4 group and 5 group.The out-patient medical healthy people were selected as control group.【Results】 The levels of T and E2 decreased,while the levels of PRL,LH,and FSH increased.The incidence of changes of gonadal hormone levels were higher in the people living at the altitude of more than 3 km.【Conclusion】 Patients of head injury had different degrees of gonadal hormone secretion.Monitoring sex hormone levels in patients with head injury and its dynamics can help assess the condition and prognosis.Altitude is the important factor that impacting the changes of sex hormones after traumatic brain injury.