创伤性脑损伤后神经内分泌变化的研究进展

The progress of neuroendocrine changes following traumatic brain injury

创伤性脑损伤(TBI)已成为影响全球的公共健康问题,过去学者们认为脑外伤不是垂体功能减退的主要原因,经过15年的研究,发现越来越多病例在TBI后存在神经内分泌紊乱的现象。虽然脑外伤后垂体功能减退的潜在机制尚未研究清楚,但最新研究发现自身免疫可能与外伤后垂体功能减退密切相关。大部分脑外伤后垂体功能减退的患者临床上不能早期诊断,是由于垂体功能减退的表现较为隐匿,不易在临床上发现,需借助激素检查来进一步诊断。早期激素替代治疗能改善患者的神经功能障碍,并促进患者康复。

Traumatic brain injury（TBI） is a well recognized public health problem worldwide. TBI has previously been considered as a rare cause of hypopituitarism, but an increased prevalence of neuroendocrine dysfunction in patients with TBI has been reported during the last 15 years in most of the retrospective and prospective studies. Although the underlying pathophysiology has not yet been fully clarified, new data indicate that autoimmunity changes may play a role in the development of hypopituitarism. Most patients with TBI-induced pituitary dysfunction remain undiagnosed and untreated because of the non-specific and subtle clinical manifestations of hypopituitarism. Replacement of the deficient hormones may not only reverse the clinical manifestations and neurocognitive dysfunction, but may also help posttraumatic disabled patients resistant to classical treatment who have undiagnosed hypopituitarism.