摘要
目的探讨甲状腺功能减低致垂体增生的内分泌激素的改变及治疗效果。方法回顾性分析8例甲状腺功能减低致垂体增生儿童(3例男性,5例女性,年龄5～9岁)的临床资料,治疗随访1～6年。结果8例患儿的甲状腺激素水平均降低,促甲状腺素(TSH)及血浆泌乳素(PRL)水平增高,予以甲状腺素替代治疗,用药2～6月后,血清游离三碘甲腺原氨酸(FT3)、游离四碘甲腺原氨酸(FT4)、TSH及PRL恢复正常,垂体体积恢复正常大小。其中6例身高增长由治疗前3.1±0.5cm/年,提高到治疗后11.6±1.7cm/年,差异有显著性(P<0.01)。另外2例儿童甲状腺素替代治疗后身高增长不理想,予以基因重组人生长激素(rhGH)治疗后,随访身高增长为11cm/年。8例均无垂体增生复发。结论对于身材矮小儿童进行甲状腺功能及垂体检查十分必要,甲状腺素替代治疗是儿童甲状腺功能减低致垂体增生的有效手段。在垂体增生恢复后仍然合并生长激素缺乏的患儿予以生长素治疗可以获得满意的身高增长。
Objective To study the changes in hormone levels and the therapy of pituitary hyperplasia secondary to primary hypothyroidism in children. Methods The clinical data of 8 children with pituitary hyperplasia secondary to primary hypothyroidism （5 gifts and 3 boys） at ages of 5 to 9 years were studied retrospectively. All of the children had a short stature. They were followed up 1 to 6 years. Results The thyroid hormone levels decreased and the serum thyroid stimulating hormone （TSH） and prolactin （PRL） levels increased in the 8 children. After 2 to 6 months thyroxine replacement therapy, the levels of free triiodothyronine （ FT3 ）, free thyroxine （FT4） and serum TSH and PRL returned to normal, and the pituitary enlargement regressed to normal in the 8 children. Of them, 6 children＇s height growth rate increased significantly from 3.1 ± 0.5 cm per year to 11.6 ± 1.7 cm per year （ P 〈 0.01 ）. The other 2 cases had low growth rate and then received additional recombinant human growth hormone （rhGH） therapy. Their height growth rate increased by 11 cm per year. Pituitary hyperplasia did not recur in the 8 children during the follow-up. Conclusions The thyroid function and pituitary examinations are necessary for children with a short stature. Thyroxine substitution therapy appears to be effective for primary hypothyroidism secondary to pituitary hyperplasia, rhGH replacement therapy after regression of the pituitary enlargement can result in a satisfactory height growth in children with low thyroid hormone levels and growth hormone deficiency.
出处
《中国当代儿科杂志》
CAS
CSCD
北大核心
2010年第1期17-20,共4页
Chinese Journal of Contemporary Pediatrics
关键词
身材矮小
甲状腺功能减低
垂体增生
生长激素
儿童
Short stature
Primary hypothyroidism
Pituitary hyperplasia
Growth hormone
Child
