【摘要】：目的通過(guò)對(duì)動(dòng)脈瘤性蛛網(wǎng)膜下腔出血患者垂體激素（ACTH、TSH、FSH、PRL、 GH、 LH）和甲狀腺激素(T3、 T4、 FT3、 FT4)含量變化的觀察，探討各激素含量變化與病情輕重、出血量及預(yù)后的關(guān)系。 臨床資料與方法以42例顱內(nèi)動(dòng)脈瘤破裂患者為研究對(duì)象，出血量按Fisher CT分級(jí)，病情輕重按Hunt-Hess分級(jí)，預(yù)后按死亡與否分組。全部42例患者均在急性期(發(fā)病后1-3天)抽血，均送往我院核醫(yī)學(xué)科及檢驗(yàn)中心進(jìn)行集中檢測(cè)。 結(jié)果①各指標(biāo)與病情輕重的關(guān)系：Hunt分級(jí)I、II級(jí)患者各指標(biāo)（ACTH、TSH、FSH、PRL、GH、LH、T3、FT3）與對(duì)照組相比無(wú)顯著性差異，P0.05；Hunt分級(jí)III級(jí)、 IV-V級(jí)患者與對(duì)照組相比有顯著性差異，， P＜0.05；各激素水平隨Hunt分級(jí)升高而升高，I級(jí)、II級(jí)雖升高，但無(wú)統(tǒng)計(jì)學(xué)意義；T4、 FT4水平不隨Hunt分級(jí)變化而變化，與對(duì)照組相比無(wú)顯著差異性，P0.05。②各指標(biāo)與出血量的關(guān)系：Fisher CT分級(jí)I、II級(jí)患者各指標(biāo)（ACTH、TSH、FSH、PRL、 GH、 LH、 T3、 FT3）與對(duì)照組相比無(wú)顯著性差異， P0.05； III級(jí)、 IV級(jí)患者與對(duì)照組相比有顯著性差異，P＜0.05；T4、 FT4水平不隨Fisher CT分級(jí)變化而變化，與對(duì)照組相比無(wú)顯著差異性，P0.05。③各指標(biāo)（ACTH、TSH、FSH、PRL、GH、LH）在死亡組與存活組之間比較差異有顯著性P＜0.05；各部位動(dòng)脈瘤之間比較，各指標(biāo)差異無(wú)顯著性，P0.05。 結(jié)論顱內(nèi)動(dòng)脈瘤破裂出血患者急性期各激素（ACTH、TSH、FSH、PRL、GH、 LH、 T3、 FT3）指標(biāo)的升高與出血量、病情輕重、預(yù)后呈正相關(guān)。出血量越多，病情越重，預(yù)后越差各指標(biāo)升高越明顯。T4、FT4含量變化與病情輕重及出血量無(wú)關(guān)聯(lián)。說(shuō)明各垂體激素及T3、FT3的變化在一定程度上反映了下丘腦-垂體功能的受損程度，可用來(lái)評(píng)估病情及判斷預(yù)后。
[Abstract]:Objective to observe the changes of pituitary hormone (GH, LH) and thyroid hormone (T _ 3, T _ 4, FT _ 3, FT4) in patients with aneurysm subarachnoid hemorrhage (SAH), and to explore the relationship between the changes of these hormones and the severity of the disease, the amount of bleeding and the prognosis. Methods 42 patients with ruptured intracranial aneurysms were studied. The amount of bleeding was classified according to Fisher CT, the severity of the disease was classified by Hunt-Hess, and the prognosis was classified by death or not. All 42 patients were taken blood in acute phase (1-3 days after onset) and were sent to our nuclear medicine department and laboratory for centralized examination. Results (1) the relationship between each index and the severity of the disease was not significantly different from that of the control group (P < 0.05), and there was a significant difference between the two groups (P < 0.05). There was a significant difference between the IV-V grade and the control group (P < 0.05), and there was no significant difference between the two groups (P < 0.05). The levels of each hormone increased with the increase of Hunt grade, but there was no significant difference between T4 and T4. The level of FT4 did not change with Hunt grade. There was no significant difference between the two groups. There was no significant difference between the two groups (P0.05.2). There was no significant difference between the two groups (P0.05), and there was no significant difference between the two groups (P0.05). There was significant difference between the III grade and the IV grade patients and the control group (P < 0.05). The FT4 level did not change with the Fisher CT grade. There was no significant difference (P < 0.05) between death group and survival group (P < 0.05). Conclusion the elevation of FT3, LH, T3, FT3 in patients with ruptured intracranial aneurysms at acute stage is positively correlated with the amount of bleeding, the severity of the disease and the prognosis. The higher the amount of bleeding, the more serious the condition, the worse the prognosis. The higher the prognosis, the more obvious the change of FT4 content in T4 was not related to the severity of the disease and the amount of bleeding. The results showed that the changes of pituitary hormones and T _ 3T _ 3FT _ 3 reflected the degree of hypothalamus-pituitary function damage to some extent, and could be used to evaluate the condition of the disease and to judge the prognosis.
【學(xué)位授予單位】：寧夏醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R743.35

【參考文獻(xiàn)】

相關(guān)期刊論文 前1條

1 何超明;顧育靜;;急性腦血管病昏迷病人甲狀腺激素水平意義[J];中國(guó)熱帶醫(yī)學(xué);2008年11期

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