19例联合性垂体功能减退患者临床特征及疗效分析

Analysis of clinical characteristics and treatment efficiency in 19 patients with combined pituitary hormone deficiency

目的探讨儿童联合性垂体功能减退(combined pituitary hormone deficiency,CPHD)患者的临床特征和疗效分析。方法对2003年7月-2015年8月吉林大学第一医院儿童内分泌与遗传代谢科门诊收治的19例CPHD患者,进行病史采集、体格检查、实验室检查等。结果垂体激素的缺乏情况,19例患者均存在生长激素缺乏,促甲状腺激素缺乏者占89%(17/19),促性腺激素缺乏者占74%(14/19),促肾上腺皮质激素缺乏者占42%(8/19),抗利尿激素缺乏者占16%(3/19),泌乳素均不缺乏;治疗方面,18例患者应用重组人生长激素(recombinant human growth hormone,rh GH)治疗12个月后身高明显改善。按激素缺乏类型不同分组,组间比较治疗后身高与P10差值的减少程度,差异无统计学意义(P>0.05)。结论儿童CPHD患者激素缺乏类型多样,保证其他轴系激素水平正常,应用rh GH治疗,对身高改善明显。

Objective To assess the clinical characteristics and treatment efficiency in children with combined pituitary hormone deficiency（ CPHD）. Methods 19 CPHD cases were retrospectively collected for medical history collection,physical examination and laboratory examination from July 2003 to August 2015 in the department of pediatric endocrinology and metabolism of the first hospital of Jilin university. Results All patients had combined pituitary hormone deficiency,including thyroid stimulating hormone deficiency 89%（ 17 /19）,gonadotrophin deficiency 74%（ 14 /19）,adrenocorticotropic hormone deficiency42%（ 8 /19） and antidiuretic hormone deficiency 16%（ 3 /19）. 18 cases,having no lack of prolactin,administrated recombinant human growth hormone（ rh GH） replacement therapy for 12 months. Comparing the height with P10 after treatment,there was no differences between groups according to the types of hormone deficiency（ P〈0. 05）. Conclusion Although CPHD children have various clinical features,to ensure other shaft hormone level staying normal,with the application of rh GH treatment,the height improvement is obvious.