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时间:2019-05-22
《垂体柄中断综合征五例分析并文献复习》由会员上传分享,免费在线阅读,更多相关内容在行业资料-天天文库。
1、万方数据·下丘脑.垂体疾病·垂体柄中断综合征五例分析并文献复习郭清华陆菊明窦京涛吕朝晖母义明杨丽娟周琳【摘要】目的分析垂体柄中断综合征(pituitarystalkinterruptionsyndrome,PSIS)患者的临床特点,提高对该类疾病的临床认识。方法采用回顾性分析的方法,对我院近7年来收治的5例PSIS患者的临床表现、实验室检查和影像学特点进行分析。结果5例PSIS患者中男性4例,女性l例。临床特征是:(1)生长发育迟缓;(2)出生时臀位分娩率高;(3)身高159—165cm,下部量大于上部量,指间距
2、小于身长;(4)骨龄落后3—8岁不等;(5)智力基本正常,但学习成绩逐渐下降;(6)有垂体前叶功能减退的临床表现和实验室检查;(7)垂体后叶功能正常;(8)垂体MRI增强扫描:垂体柄未见,垂体小,后叶异位。PSIS的发病机制不详。垂体前叶激素替代治疗是唯一有效的治疗方式,但要把握治疗时机。结论PSIS发病率低,临床特征不同于单纯性垂体侏儒和低促性腺激素性性腺功能减退,临床应提高认识,把握治疗时机。【关键词】垂体柄中断综合征;临床特征;治疗Clinicalanalysisof5easesofpituitarysta
3、lkinterruptionsyndromeandHteraturereviewGUOQing—hua,LuJu—ming,DOUring—tao,L£7Zhao一^“i,MUYi—ruing,YANGLi-juan,ZHOULin.DepartmentofEndocrinology,ChinesePLAGeneralHospital,Beijing100853,ChinaCorrespondingauthor:LUJu·mi,W【Abstract】objectiveToanalyzetheclinicalcha
4、racteristicsofthepatientswithpituitarystalkinterruptionsyndrome(PSIS)inourhospitalinthepastsevenyears,andtoachievebettercomprehensionofthiskindofdisease.MethodsFivepatientswithPSIS(4males,1female)inourhospitalwereretrospectivelyanalyzed,regardingclinicalmanif
5、estation,laboratoryandimagingdata.ResultsTheclinicalfeaturesof5ca..ge$ofPSISwereasfollows:(1)growthretardation;(2)highincidenceofbreechdelivery;(3)159—165cminbodyheight(4)retardedboneage;(5)averageintelligence;(6)adenohypophysealdysfunctioninclinicalandlabora
6、toryexaminations;(7)normalposteriorpituitaryfunction;(8)MRlwithgadoliniumcontrastrevealednopituitarystalkandanteriorpituitaryhypoplasiawitheetopicposteriorpituitary.ThepathogenesisofPSISisnotclear.Appropriatehormonalreplacementtherapyistheonlyeffectiveway.Con
7、clusionPSISisrarelyseenanditsclinicalfeatureisdifferentfrompituitarydwarfismandhypogonadotropichypogonadism.Therealizationforthissyndromeshouldbeemphasizedandearlytherapyisessential.【Keywords】Pituitarystalkinterruptionsyndrome;Clinicalcharacteristics;Therapy(
8、Chin.,EndocrinolMetab,2008。24:480-482)垂体柄中断综合征(pituitarystalkinterruptionsyndrome,PSIS)是指垂体柄缺如合并垂体后叶异位,下丘脑分泌的激素不能通过垂体柄输送到垂体所致的临床系列征候群¨J。临床极为罕见,国内外相关报道不多。随着MRI的临床应用,该病逐渐有个案报道【1引。现将我院近7年来收治
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