トラウマ性脳損傷と動脈下下関節出血後の下垂体垂体機能不全:体系的なレビュー
Harald Jörn Schneider1, Ilonka Kreitschmann-Andermahr, Ezio Ghigo
1Neuroendocrinology Group, Max Planck Institute of Psychiatry, Munich, Germany. schneider@mpipsykl.mpg.de
JAMA
|September 27, 2007
まとめ
低垂体症は,外傷性脳損傷と頭下関節下出血の後の一般的な合併症であり,生活の質に影響を及ぼします. 早期発見と治療は,よりよい回復結果を出すために不可欠です.
科学分野:
- 神経内分泌学の神経内分泌学
- 神経学 神経学とは
- 内科内科は,内科の内科である.
背景:
- 神経内分泌機能不全は,脳外傷 (TBI) と動脈下下関節出血 (aSAH) の後の頻繁な,まだ診断されていない合併症です.
- この後遺症は,重症であるが治療可能な状態であり,患者の回復に影響を及ぼします.
研究 の 目的:
- TBIおよびaSAH後の下垂体前皮質機能不全に関する既存の研究をレビューする.
- トラウマ後の下垂体関節症の自然史と臨床的影響を理解する.
主な方法:
- MEDLINEデータベース (2000年~2007年) で,体系的な文献検索が行われました.
- キーワードには,TBI,aSAH,および特定の下垂体ホルモン欠乏症が含まれています.
- 1137人の患者を対象とした19件の研究から得られたデータは,流行率を計算するためにまとめた.
主要な成果:
- プーリングされた下垂体症の罹患率は,TBI後の27.5%,aSAH後の47%でした.
- 軽度/中等度の症例と比較して,重度のTBI患者ではより高い罹患率が観察されました.
- 神経内分泌の異常は,一時的であり,時間とともに進化し,生活の質や代謝の健康に影響を与える可能性があります.
結論:
- 低垂体症は,TBIとaSAHの後に発生する一般的な合併症です.
- それは罹病率に大きく寄与し,脳損傷後の回復を阻害する可能性があります.
- この診断不足の状態については,さらなる研究と臨床的注意が必要である.
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