垂体功能减退与动脉硬化性脑梗死预后的关系

Prognostic Significance of Hypopituitarism in Acute Atherosclerotic Cerebral Infarction

目的探讨脑梗死伴发垂体功能减退在动脉粥样硬化性脑梗死预后预测中的意义。方法本研究纳入2016年1月-2018年8月在医院神经科病房住院发病21天内缺血性脑卒中患者129例;并采用化学发光免疫法检测垂体功能。收集患者性别,年龄,高血压,2型糖尿病,脑梗死面积,脑血管狭窄程度等指标,电话随访其3个月后改良Rankin量表(modified rankin scale,mRS)评分,分析脑梗死伴发垂体功能减退在动脉粥样硬化性脑梗死90天预后的预测意义。结果所有患者中101例预后良好,28例预后不良。单因素分析显示女性、大面积脑梗死、垂体功能减退、高NIHSS评分是急性脑梗死发病3个月预后不良的可疑影响因素(P<0.05),多因素分析显示:性别(OR=6.167,95%CI:1.315~10.203,P=0.013)、NIHSS评分≥8分(OR=5.944,95%CI:1.348~15.648,P=0.033)、早期垂体功能减退(OR=4.567,95%CI:1.094~8.066,P=0.015)是急性脑梗死3个月预后不良的独立危险因素(P<0.05)。结论脑梗死后早期垂体功能减退是急性动脉粥硬化性脑梗死90天预后不良的独立危险因素,临床中需加以重视。

Objective To investigate the prognostic significance of pituitary function among patients with hypopituitarismin acute atherosclerotic cerebral infarction.Methods This study included 129 patients with ischemic stroke who were hospitalized in neurological ward from January 2016 to August 2018.Chemiluminescence immunoassay was used to detect pituitary function.Thepotential etiological factorsincluded gender,age,hypertension,type 2 diabetes mellitus,cerebral infarction area,cerebral stenosis degree of cerebral artery etc.The modified Rankin score(mRS)was assessed 90-dayspoststroke via telephone.Correlation between hypopituitarismand prognostic outcomes were analyzed.Results Among all patients,101 cases had good prognosis and 28 cases had poor prognosis.Thegender(OR=6.167,95%CI:1.315~10.203,P=0.013),NIHSS score≥8(OR=5.944,95%CI:1.348~15.648,P=0.033),Hypopituitarism(OR=4.567,95%CI:1.094~8.066,P=0.015)were acute cerebral infarction 3 months for a poor prognosis with questionable effect factors(P<0.05).Conclusion Hypopituitarism is an independent risk factor for poor prognosis in patients with acute atherosclerotic cerebral infarction.