目的探讨创伤性颅脑损伤(TBI)急性期后甲状腺激素和生殖激素的改变及相关因素.方法选取2009年9月～2010年3月本院神经康复科外伤30 d后的70例重度TBI患者为研究对象.住院次日7:00～8:00测量基础垂体前叶激素值.计算总异常发生率和单一激素异常发生率.并根据生殖激素和甲状腺激素水平,将受试对象分别分为正常组(n<,1>=46,n<,2>=29)与异常组(n<,1>=24,n<,2>=30),评估正常组与异常组在性别、年龄、病程、昏迷时间、是否存在颅底骨折以及残疾等级量表(DRS)评分方面的差异.结果急性期后重度TBI患者垂体前叶激素异常总发生率为77.1%.检测所有激素水平均有不同程度异常,生殖激素异常率较高,睾酮异常发生率25.4%;甲状腺功能中,促甲状腺激素异常发生率为15.7%.生殖激素异常组DRS评分明显高于生殖激素正常组,生殖激素异常组昏迷时间明显长于生殖激素正常组.结论急性期后重度TBI患者甲状腺激素和生殖激素异常发生率高.生殖激素异常与昏迷时间相关.%Objective To observe the changes of thyroid hormone and reproductive hormone in post-acute traumatic brain injury (TBI). Methods 70 post-acute TBI patients were selected from Beijing Charity Hospital from September 2009 to March 2010. The levels of thyroid stimulating hormone (TSH), triiodothyronine (T3), thyroxine ( T4 ), free triiodothyronine (FT3), free thyroxine (FT4), follicie stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2), progesterone (P), and testosterone (T)were measured at 7 a.m. to 8 a.m. on the second day of admisson. According to the reference ranges, the total abnormal rate and the single hormone abnormal rate were calculated. According to the level of hormone, the subjects were divided into the normal group and the abnormal group. The two groups were compared in gender, age, course of disease, duration of coma, basal fracture and scores of Disability Rating Scale (DRS). Results The total abnormal incidence of anterior pituitary hormone was 77. 1％ in postacute TBI. The abnormality of reproductive hormones was higher. The duration of coma was related to the reproductive hormone.Conclusion The abnormal incidence of anterior pituitary hormone occurs frequently in post-acute TBI. The duration of coma is related to the reproductive hormone.
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