The Change of the Anterior Pituitary Hormone and the Clinical Significance in the Severe Traumatic Brain Injury
|School||Tianjin Medical University|
|Keywords||sTBI Anterior pituitary hormones Chemiluminescence Hormone replacement therapy|
Background: Traumatic brain injury (traumatic brain injury TBI) has become a serious threat to public health problems. Recent studies have found, TBI after the incidence of anterior pituitary hormone abnormalities is not low, the pituitary dysfunction may cause or aggravate hypothyroidism caused by TBI patients physical, cognitive, psychological damage and affect rehabilitation, such as timely discovery anterior pituitary hormone abnormalities and variation of leaf and take effective treatment measures, is likely to increase for injury assessment and prognostic accuracy, and improve the prognosis of patients with TBI. Objective: Determination of Heavy TBI (sTBI) at different time points after injury in patients serum growth hormone (GH), thyroid stimulating hormone (TSH), follicle stimulating hormone (FSH), luteinizing hormone (LH) and prolactin (PRL) of content, and explore the incidence of anterior pituitary hormone abnormalities, as well as variation of the relationship between the injury and prognosis. For the clinical diagnosis of post-traumatic anterior pituitary hormone abnormalities and use of hormone replacement therapy to improve the prognosis of patients with more research data. Methods: Randomly selected in January 2006 - December 2006 among 48 patients hospitalized with acute sTBI as brain trauma group, and then admission GCS is divided into different groups and extra-heavy heavy group. 1,7,14,21 days after injury in patients with venous blood was extracted from 3ml, separation of serum, using chemiluminescence anterior pituitary hormones. Another 20 healthy volunteers were randomly selected as a control group, venous blood were measured once. Above age group, gender, no significant differences. Traumatic brain injury patients at 3 months after injury, according to medical records or follow-up results, according to GOS score standards are divided into poor prognosis group (GOS ≤ 3) and good prognosis group (GOS> 3). Results: (1) after injury, abnormal FSH and LH can achieve a high incidence of 52.1% and 45.8%. (2) heavy and extra-heavy group group on day 1 after injury GH and TSH levels compared with the control group was statistically significant (P <0.05). Heavy and extra-heavy group group after injury 1,7,14,21 days FSH and LH levels compared with the control group was statistically significant (P <0.05). Heavy and extra-heavy group group was not statistically significant (P> 0.05). (3) poor prognosis patients on day 1 after injury TSH levels with good prognosis group was statistically significant (P <0.05), followed by the three determinations and also has a good prognosis group was statistically significant (P <0.05). Patients with poor prognosis after injury 1,7,14,21 days FSH and LH levels and good prognosis group was statistically significant (P <0.05). Poor prognosis group on day 1 after injury GH and PRL levels with good prognosis group was statistically significant (P <0.05). Conclusions: (1) sTBI FSH and LH changes occur after the most common. (2) after injury, anterior pituitary hormones may change significantly, heavy and extra-heavy group group on day 1 after injury GH and TSH higher, heavy and extra-heavy group of 1,7,14,21 days after injury The FSH and LH levels than the control group, with the condition improved after injury and secretion of pituitary function over time showed varying degrees of recovery. STBI patients with acute anterior pituitary hormone changes after injury, the degree of injury is no obvious connection. (3) sTBI pituitary hormones in patients after injury, the prognosis for the dynamic change has important reference value, usually the first day after the injury occurred anterior pituitary hormone levels were significantly higher or lower than normal, and then was sustained low levels, suggesting that the prognosis bad; 1st day after injury of anterior pituitary hormone levels changed significantly but is able to quickly recover and little change in hormone levels after injury, suggesting a good prognosis.