垂体腺瘤术后垂体激素水平变化趋势探讨

Post-operative changes of the pituitary hormone level for pituitary adenoma patients

目的探讨垂体腺瘤术后垂体激素水平的总体变化规律。方法回顾2011年1月至2013年12月我院经蝶入路切除、并经病理证实的垂体腺瘤218例,根据筛选条件选出81例,其中男43例,女38例,根据免疫组化及临床内分泌学特点进行分组。将术前1周内、术后第1天、术后第7天及术后4个月的激素水平进行记录和比较。结果 "总体激素"水平在所有病例的术后第1天、术后第7天及术后4个月呈上升趋势。在各组垂体腺瘤中,术后第1天与术后第7天的各单项激素水平均无统计学差异(P>0.05)。结论经蝶入路手术切除垂体腺瘤后,术后第7天与术后第1天的单项激素值大致相仿,腺垂体的总体内分泌能力在术后4个月内逐步恢复。

Objective The study aims to probe into the total changes of post-operative hormone levels in pituitary adenoma patients. Methods A total of 218 eases of pituitary adenoma patients （later histologically verified） who undergone microscopic endonasal transsphenoidal surgery between January 2011 and December 2013 were analyzed retrospectively. And then 81 cases were selected for this study （43 males and 38 females） and were classified into different groups according to immunohistochemieal and clinical endocrinology The hormone levels at pre-operative 1 w, post-operative 1 d, 7 d, and 4 months were recorded individually and compared among different groups. Results All the indices including prolaetin （PRL）, growth hormone （GH）, follicle stimulating hormone （FSH）, luteotropic hormone （LH）, thyroid stimulating hormone （TSH） and adrenocortieotropic hormone （ACTH） had a rise trend at 1 d, 7 d and 4 months after surgery gradually. There was no significant difference in hormone value （including PRL, GH, FSH, LH, TSH and ACrH） in each group between 1 d and 7 d post-operatively （P〉0.05）. Conclusion The hormone levels are substantially similar at 1 d and 7 d after transsphenoidal resection of pituitary adenomas, but the total endocrine ability of the adenohypophysis gets recovery gradually within 4 months after surgery.