垂体前叶功能减退症314例临床分析

Hypofunction of Anterior Pituitary: Clinical Analysis of 314 Cases

目的总结垂体前叶功能减退症的病因、临床表现,分析其误诊情况。方法对314例垂体前叶功能减退症患者的一般资料、病因、临床表现、实验室检测进行回顾性分析。结果男126例,女188例;其中席汉氏综合征120例,垂体瘤及术后114例,颅咽管瘤28例,生殖细胞瘤2例,空泡蝶鞍13例,垂体囊肿3例,鼻咽癌放化疗术后1例。在能够提供既往诊疗病史的患者中被误诊为甲减者13例,胃炎、肠炎25例,不同类型贫血20例,脑炎6例,精神疾病6例,低血糖7例,低钠血症14例,尚有个别被误诊断为冠心病、慢性咽炎、美尼尔综合征、病毒性心肌炎、抗利尿激素分泌失调综合征、多发性肌炎、肾炎、蛋白尿待诊等。结论垂体前叶功能减退症的一些重要的症状、体征易被忽视,误诊率高,在临床工作中应予以重视,应对高危患者进行筛查以及早发现早治疗。

Objective To summarize the causes,clinical manifestations of the anterior pituitary hypothyroidism. Methods 314 cases of hypofunction of anterior pituitary were retrospectively analyzed by general information,etiology,clinical manifestations,and laboratory tests. Results There were 126 male and 188 female,including 120 Sheehan syndrome,114 pituitary tumors,28 craniopharyngioma,2 Germinoma,13 vacuoles sella,3 pituitary cyst,and 1 nose pharyngealcancer chemotherapy and surgery. some of them were misdiagnosed with hypothyroidism,gastritis,enteritisin,anemia,encephalitis,mental illness,hypoglycemia,hyponatremia,coronary artery disease,chronic pharyngitis,Meniere syndrome,viral myocarditis,syndrome of inappropriate secretion of antidiuretic hormone,polymyositis,glomerulonephritis,proteinuria,and so on. Conclusion Anterior pituitary hypofunction involved multiple systems,and was easy to be misdiagnosed.