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目的探讨甲状腺功能减退症(甲减)与垂体发育的相关性。方法选取2009年12月—2015年12月收治的多种垂体激素缺乏症患者(multiple pituitary hormone deficiency,MPDH)44例,其中继发性甲减24例为继发性甲减组,非继发性甲减20例为非继发性甲减组;选取同期收治的甲减患儿40例为对照组,按照否合并有垂体增生分为垂体增生组30例和无垂体增生组10例;比较各组甲状腺激素水平(FT3、FT4、TSH)、生长激素(GH)、皮质醇(COR)、泌乳素(PRL)、垂体分泌卵泡刺激素(FSH),采用SPSS18.0进行统计学分析。结果继发性甲减组FT3、FT4、GH峰值、COR低于非继发性甲减组,PRL高于非继发性甲减组,差异均有统计学意义(均P<0.05);其中FT4与GH峰值、COR、FSH呈正相关,与呈PRL负相关(均P<0.05);垂体增生组TSH、PRL高于无垂体增生组,FT3、FT4低于无垂体增生组,差异均有统计学意义(均P<0.05)。血清FSH与FT3水平呈负相关(均P<0.05)。结论甲减与垂体发育不良、增生有一定的关系,一旦发现需要及时治疗,以免引起严重后果。
Objective To investigate the relationship between hypothyroidism (hypothyroidism) and pituitary development. Methods Forty-four patients with multiple pituitary hormone deficiency (MPDH) were enrolled from December 2009 to December 2015. Among them, 24 cases of secondary hypothyroidism were secondary hypothyroidism, non-secondary Twenty cases of hypothyroidism were non-secondary hypothyroidism group. 40 cases of hypothyroidism treated in the same period were selected as the control group. According to whether there were pituitary hyperplasia or not, 30 cases were divided into pituitary hyperplasia group and 10 cases without pituitary hyperplasia group. Thyroid hormone levels (FT3, FT4, TSH), growth hormone (GH), cortisol (COR), prolactin (PRL) and pituitary follicle stimulating hormone (FSH) were measured with SPSS18.0 software. Results The peak values of FT3, FT4 and GH in secondary hypothyroidism group were lower than those in non-secondary hypothyroidism group and higher in PRL group than in non-hypothyroidism group (all P <0.05). Among them, There was a positive correlation between FT4 and peak of GH, COR, FSH and negatively correlated with PRL (all P <0.05). The levels of TSH and PRL in pituitary hyperplasia group were higher than those in non-pituitary hyperplasia group, but FT3 and FT4 were lower than those in pituitary hyperplasia group Significance (both P <0.05). Serum FSH was negatively correlated with FT3 level (all P <0.05). Conclusion hypothyroidism hypoplasia, hyperplasia have a certain relationship, once found need for timely treatment, so as not to cause serious consequences.