CAJ | 학술논문

目的探讨腺垂体功能减退症临床特点及病因诊断与鉴别.方法回顾性分析我院2007年1月至2011年9月收治的共260例腺垂体功能减退症患者的临床资料.结果 260例中,男性96例、女性164例,女性发病年龄(44±16)岁,明显高于男性的(32±20)岁,两者比较差异有统计学意义(t =3.821,P =0.001).男性20岁以前发病者所占比例最高,为39.6％(38例),女性以40～60岁所占比例最高,为52.4％(86例);最常见病因为垂体瘤及其术后损伤共94例(36.2％),其次为席汉综合征86例(33.1％);最常见临床表现为贫血(102例),26例患者表现为全腺垂体功能减退;大多数病因导致的腺垂体功能减退症均具有特异性垂体影像学表现;误诊率为40.4％(105/260),病因诊断时误诊率为25.4％(66/260).结论腺垂体功能减退症女性40 ～60岁、男性20岁以下者居多,病因以垂体瘤及其手术损伤最多,贫血为最常见的临床表现,误诊率较高.通过病史、临床表现及垂体影像学检查,可做出诊断与鉴别.
목적 탐토선수체공능감퇴증림상특점급병인진단여감별.방법 회고성분석아원2007년1월지2011년9월수치적공260례선수체공능감퇴증환자적림상자료.결과 260례중,남성96례、녀성164례,녀성발병년령(44±16)세,명현고우남성적(32±20)세,량자비교차이유통계학의의(t =3.821,P =0.001).남성20세이전발병자소점비례최고,위39.6％(38례),녀성이40～60세소점비례최고,위52.4％(86례);최상견병인위수체류급기술후손상공94례(36.2％),기차위석한종합정86례(33.1％);최상견림상표현위빈혈(102례),26례환자표현위전선수체공능감퇴;대다수병인도치적선수체공능감퇴증균구유특이성수체영상학표현;오진솔위40.4％(105/260),병인진단시오진솔위25.4％(66/260).결론 선수체공능감퇴증녀성40 ～60세、남성20세이하자거다,병인이수체류급기수술손상최다,빈혈위최상견적림상표현,오진솔교고.통과병사、림상표현급수체영상학검사,가주출진단여감별.
Objective To review the clinical features,etiology and differential diagnosis of hypopituitarism.Methods The clinical data of 260 patients with hypopituitarism admitted to our hospital during 2007 to 2011 were retrospectively analyzed.Results In 260 patients 96 were males and 164 were females,the average age of female patients was significantly higher than that of males[ (44 ± 16) vs.(32 ± 20) years; t =3.821,P =0.001 ].Patients under 20 years accounted for the highest proportion in male cases (38/96,39.6％) ; while patients aged 40 - 60 years were the highest proportion for female cases (86/164,52.4％).Pituitary tumor and postoperative damage was the most common cause for hypopituitarism accounting for 36.2％ (94/260),followed by Sheehan syndrome (86/260,33.1％).The most common manifestation of hypopituitarism was anemia (102 eases) ; 26 cases presented all pituitary function failure.The causes leading to hypopituitarism usually showed specific manifestations in imaging examinations.The overall misdiagnosis rate was 40.4％ (105/260)in this series,while that of etiological diagnosis was 25.4％ (66/260).Conclusions This study suggests that hypopituitarism caused by different causes can be diagnosed by disease history,clinical manifestations and pituitary imaging examination.