腺垂体功能减退症临床特征变化分析

Analysis of the changes of clinical characteristics of hypopituitarism

目的探讨腺垂体功能减退症患者的病因结构变化及临床表现。方法回顾性分析我院2013-01—2016-12住院及门诊78例腺垂体功能减退症患者的临床资料。结果男32例(41.03%),女46例(58.97%);诊断时年龄11~89岁,平均62.5岁;鞍区占位(包括术前及术后)52例(66.67%),席汉综合征8例(10.26%),空泡蝶鞍9例(11.65%),病因不明8例(10.26%),垂体-下丘脑发育不良1例(1.28%)。首次就诊科室:纳差厌食、恶心呕吐就诊于消化内科36例(46.15%)最常见。ACTH+TSH+Gn+G激素缺乏为19例最多,占24.36%,ACTH+TSH+Gn缺乏15例,占19.23%。结论腺垂体功能减退症病因结构发生变化,发病人群、首发症状及受累激素也不同,患者女性多于男性,发病年龄偏高,症状不典型,分布于临床多个科室,其中以低钠血症为首发临床表现就诊消化内科最多。

Objective To investigate the clinical characteristics of patients with hypopituitarism. Methods A retrospective analysis was carried out on the data of 78 patients with pituitary dysfunction in our hospital from January 2013 to December 2016. Results There were 32 male patients （41.03%）＇ and 46 female patients （58.97%） ,ageing between 11-89;with an average age of （62.5±5.4） years old,there were 52 cases with seilar tumors （66.67%）,in which including preoperative and postoperative,8 cases （10.26%） of Sheehan syndrome,9 cases of empty sella （11. 540/00） ,8 cases of unknown etiology （10.26%） ,and 1 case of pitu- itary hypothalamic dysplasia（1.28-）. The most common of 36 cases （46.15%） with hyponatremia with the first symptoms of anorexia,nausea,and vomiting to be treated in gastroenterology department. The lack of hormone to ACTH ＋ TSH ＋ Gn ＋ G deficiency was 19 cases,accounting for 24.36% ,ACTH ＋ TSH ＋ Gn deficiency in 15 cases,accounted for 19.23%. Conclusion Owing to the difference in etiological factors, the incidence, early symptoms, and the hormones involved are also different, which occurred more in aged person,more in males than female, in addition, symptoms are not typical, it distributed in various depart- ments,which with hyponatremia as the first clinical manifestations of treatment of most of the gastroenterology.