Chinese General Practice ›› 2023, Vol. 26 ›› Issue (06): 699-703.DOI: 10.12114/j.issn.1007-9572.2022.0591
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Received:
2022-02-20
Revised:
2022-09-10
Published:
2023-02-20
Online:
2022-10-09
Contact:
SUN Tongwen
About author:
通讯作者:
孙同文
作者简介:
基金资助:
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URL: https://www.chinagp.net/EN/10.12114/j.issn.1007-9572.2022.0591
病例 | 性别 | 诊断垂体功能减退时年龄(岁) | 诊断肝硬化时年龄(岁) | 相隔时间(年) | 垂体功能减退原因 |
---|---|---|---|---|---|
1 | 女 | 9 | 23 | 14 | 生殖细胞瘤术后 |
2 | 男 | 13 | 16 | 3 | 颅咽管瘤术后 |
3 | 男 | 10 | 16 | 6 | 垂体柄阻断综合征 |
4 | 男 | 9 | 20 | 11 | 鼻咽癌放疗后 |
5 | 男 | 20 | 24 | 4 | 颅咽管瘤术后 |
6 | 男 | 12 | 22 | 10 | 生殖细胞瘤术后 |
7 | 男 | 10 | 21 | 11 | 生殖细胞瘤术后 |
8 | 女 | 13 | 17 | 4 | 生殖细胞瘤术后 |
Table 1 Clinical features of 8 cases of hepatic cirrhosis secondary to hypopituitarism
病例 | 性别 | 诊断垂体功能减退时年龄(岁) | 诊断肝硬化时年龄(岁) | 相隔时间(年) | 垂体功能减退原因 |
---|---|---|---|---|---|
1 | 女 | 9 | 23 | 14 | 生殖细胞瘤术后 |
2 | 男 | 13 | 16 | 3 | 颅咽管瘤术后 |
3 | 男 | 10 | 16 | 6 | 垂体柄阻断综合征 |
4 | 男 | 9 | 20 | 11 | 鼻咽癌放疗后 |
5 | 男 | 20 | 24 | 4 | 颅咽管瘤术后 |
6 | 男 | 12 | 22 | 10 | 生殖细胞瘤术后 |
7 | 男 | 10 | 21 | 11 | 生殖细胞瘤术后 |
8 | 女 | 13 | 17 | 4 | 生殖细胞瘤术后 |
病例 | 抗利尿激素 | 垂体-甲状腺轴 | 垂体-性腺轴 | 垂体-肾上腺轴 | GH | IGF-1 | 激素补充情况 |
---|---|---|---|---|---|---|---|
1 | + | + | + | + | + | + | 无激素替代 |
2 | + | + | + | + | + | + | 间断氢化可的松及甲状腺激素替代 |
3 | + | + | + | - | + | + | 间断GH及甲状腺激素替代 |
4 | - | + | + | - | + | + | 间断甲状腺激素替代 |
5 | + | + | + | + | + | + | 间断氢化可的松及甲状腺激素替代 |
6 | + | + | + | + | + | + | 无激素替代 |
7 | + | + | + | + | + | + | 间断氢化可的松及甲状腺激素 |
8 | + | + | + | + | + | + | 醋酸去氨加压素片、泼尼松、甲状腺激素替代1个月后停药 |
Table 2 Endocrine examination and hormone supplement treatment in 8 cases of hepatic cirrhosis secondary to hypopituitarism
病例 | 抗利尿激素 | 垂体-甲状腺轴 | 垂体-性腺轴 | 垂体-肾上腺轴 | GH | IGF-1 | 激素补充情况 |
---|---|---|---|---|---|---|---|
1 | + | + | + | + | + | + | 无激素替代 |
2 | + | + | + | + | + | + | 间断氢化可的松及甲状腺激素替代 |
3 | + | + | + | - | + | + | 间断GH及甲状腺激素替代 |
4 | - | + | + | - | + | + | 间断甲状腺激素替代 |
5 | + | + | + | + | + | + | 间断氢化可的松及甲状腺激素替代 |
6 | + | + | + | + | + | + | 无激素替代 |
7 | + | + | + | + | + | + | 间断氢化可的松及甲状腺激素 |
8 | + | + | + | + | + | + | 醋酸去氨加压素片、泼尼松、甲状腺激素替代1个月后停药 |
指标 | 治疗前 | 治疗后 | t配对值 | P值 | |
---|---|---|---|---|---|
血常规 | |||||
白细胞计数(×109/L) | 3.3±1.2 | 3.8±1.2 | -4.216 | <0.05 | |
血红蛋白(g/L) | 90.6±16.7 | 92.1±16.7 | -1.214 | >0.05 | |
血小板计数(×109/L) | 61.4±12.1 | 68.9±12.5 | -2.942 | <0.05 | |
肝功能 | |||||
丙氨酸氨基转移酶(U/L) | 37.8±23.0 | 35.2±8.7 | 0.456 | >0.05 | |
天冬氨酸氨基转氨酶(U/L) | 58.0±19.1 | 46.3±14.0 | 2.520 | <0.05 | |
谷氨酰转肽酶(U/L) | 122.1±90.8 | 71.8±67.0 | 1.148 | >0.05 | |
碱性磷酸酶(U/L) | 163.8±79.8 | 135.6±53.6 | 2.825 | <0.05 | |
总胆红素(mmol/L) | 56.6±30.4 | 46.1±22.3 | 2.764 | <0.05 | |
直接胆红素(mmol/L) | 23.8±18.1 | 20.9±11.3 | 0.941 | >0.05 | |
间接胆红素(mmol/L) | 32.9±20.3 | 25.3±13.9 | 2.562 | <0.05 | |
血脂 | |||||
总胆固醇(mmol/L) | 3.9±1.1 | 3.5±0.6 | 1.446 | <0.05 | |
低密度脂蛋白胆固醇(mmol/L) | 2.2±1.1 | 2.0±0.6 | 0.909 | <0.05 | |
高密度脂蛋白胆固醇(mmol/L) | 0.8±0.5 | 0.9±0.5 | -2.872 | <0.05 | |
三酰甘油(mmol/L) | 2.6±1.8 | 1.9±1.0 | 1.610 | >0.05 | |
凝血功能 | |||||
凝血酶原时间(s) | 14.9±3.4 | 14.0±4.1 | 1.336 | >0.05 | |
内源性凝血酶原时间(s) | 39.8±9.8 | 36.5±8.7 | 2.323 | >0.05 | |
纤维蛋白原(g/L) | 1.7±0.9 | 2.0±0.7 | -2.542 | <0.05 | |
D-二聚体(mg/L) | 0.7±0.4 | 0.7±0.5 | -0.310 | >0.05 | |
肝纤四项 | |||||
Ⅳ型胶原(μg/L) | 122.3±43.1 | 114.5±45.6 | 2.805 | <0.05 | |
透明质酸(μg/L) | 134.9±40.5 | 123.9±36.3 | 4.179 | <0.05 | |
Ⅲ型前胶原N端肽(μg/L) | 45.5±26.8 | 37.0±20.3 | 3.032 | <0.05 | |
层粘连蛋白(μg/L) | 177.1±59.6 | 150.8±51.4 | 5.333 | <0.05 |
Table 3 Comparison of laboratory inspection indexes before and after one-year treatment in 8 cases of hepatic cirrhosis secondary to hypopituitarism
指标 | 治疗前 | 治疗后 | t配对值 | P值 | |
---|---|---|---|---|---|
血常规 | |||||
白细胞计数(×109/L) | 3.3±1.2 | 3.8±1.2 | -4.216 | <0.05 | |
血红蛋白(g/L) | 90.6±16.7 | 92.1±16.7 | -1.214 | >0.05 | |
血小板计数(×109/L) | 61.4±12.1 | 68.9±12.5 | -2.942 | <0.05 | |
肝功能 | |||||
丙氨酸氨基转移酶(U/L) | 37.8±23.0 | 35.2±8.7 | 0.456 | >0.05 | |
天冬氨酸氨基转氨酶(U/L) | 58.0±19.1 | 46.3±14.0 | 2.520 | <0.05 | |
谷氨酰转肽酶(U/L) | 122.1±90.8 | 71.8±67.0 | 1.148 | >0.05 | |
碱性磷酸酶(U/L) | 163.8±79.8 | 135.6±53.6 | 2.825 | <0.05 | |
总胆红素(mmol/L) | 56.6±30.4 | 46.1±22.3 | 2.764 | <0.05 | |
直接胆红素(mmol/L) | 23.8±18.1 | 20.9±11.3 | 0.941 | >0.05 | |
间接胆红素(mmol/L) | 32.9±20.3 | 25.3±13.9 | 2.562 | <0.05 | |
血脂 | |||||
总胆固醇(mmol/L) | 3.9±1.1 | 3.5±0.6 | 1.446 | <0.05 | |
低密度脂蛋白胆固醇(mmol/L) | 2.2±1.1 | 2.0±0.6 | 0.909 | <0.05 | |
高密度脂蛋白胆固醇(mmol/L) | 0.8±0.5 | 0.9±0.5 | -2.872 | <0.05 | |
三酰甘油(mmol/L) | 2.6±1.8 | 1.9±1.0 | 1.610 | >0.05 | |
凝血功能 | |||||
凝血酶原时间(s) | 14.9±3.4 | 14.0±4.1 | 1.336 | >0.05 | |
内源性凝血酶原时间(s) | 39.8±9.8 | 36.5±8.7 | 2.323 | >0.05 | |
纤维蛋白原(g/L) | 1.7±0.9 | 2.0±0.7 | -2.542 | <0.05 | |
D-二聚体(mg/L) | 0.7±0.4 | 0.7±0.5 | -0.310 | >0.05 | |
肝纤四项 | |||||
Ⅳ型胶原(μg/L) | 122.3±43.1 | 114.5±45.6 | 2.805 | <0.05 | |
透明质酸(μg/L) | 134.9±40.5 | 123.9±36.3 | 4.179 | <0.05 | |
Ⅲ型前胶原N端肽(μg/L) | 45.5±26.8 | 37.0±20.3 | 3.032 | <0.05 | |
层粘连蛋白(μg/L) | 177.1±59.6 | 150.8±51.4 | 5.333 | <0.05 |
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