在创伤性脑损伤的急性阶段前垂体功能的动力学:一个潜在的队列队列
Eder Cáceres1,2, Juan Olivella-Gómez3, André Emilio Viñán Garcés3
1Unisabana Center for Translational Science, School of Medicine, Universidad de La Sabana - Chía, Colombia.
Critical care science
|October 31, 2025
概括
前垂体激素障碍在创伤性脑损伤 (TBI) 后很常见,功能障碍的严重程度与损伤的严重程度有关. 激素水平与死亡率或长期残疾结果没有相关性.
科学领域:
- 内分泌学 在内分泌学.
- 神经科学是一个神经科学.
- 创伤护理 创伤护理
背景情况:
- 创伤性脑损伤 (TBI) 经常会破坏下丘脑-垂体轴.
- 前垂体激素功能障碍是TBI的潜在并发症.
- 了解TBI后的急性垂体功能对于患者管理至关重要.
研究的目的:
- 在TBI后的急性阶段评估前垂体腺功能.
- 为了研究垂体激素水平和患者的结果之间的关系.
- 为了确定TBI严重程度和脑垂体功能障碍之间的相关性.
主要方法:
- 88名在重症监护中的TBI患者的前性队列研究.
- 在受伤后的0,3,7天测量上腺皮质激素,生长激素和甲状腺刺激激素.
- 使用格拉斯哥结果扩展尺度 (GOSE) 评估六个月的结果.
主要成果:
- 观察到高频率的非正常激素水平:ACTH (81%的第0天),GH (76%的第0天),TSH (42%的第0天).
- 创伤严重程度与第0天ACTH和第7天GH水平相关.
- 质纤维性星细胞蛋白与ACTH和TSH水平存在关联,但没有发现激素水平与死亡率或GOSE得分之间的显著联系.
结论:
- 前垂体激素障碍在TBI后普遍存在,并且与受伤严重程度有关.
- 目前的发现表明,急性垂体功能障碍与死亡率或残疾之间没有关联.
- 需要进一步的研究来标准化垂体功能评估,并澄清其TBI的预后和治疗影响.
相关概念视频
Traumatic Brain Injury l: Introduction
DefinitionTraumatic brain injury, or TBI, is a disturbance of normal brain function induced by an external mechanical force, such as a direct blow to the head or a penetrating injury. It can affect both brain structure and function, producing a wide range of clinical outcomes. TBI is a heterogeneous condition, meaning its effects may differ based on the type, location, and severity of the injury.Basis of ClassificationTBI is classified based on severity, injury mechanism, or pathophysiology. In...
Increased Intracranial Pressure l: Introduction
Intracranial hypertension is a sustained elevation of intracranial pressure (ICP) above 22 mm Hg. In supine adults, normal ICP is ~7–15 mm Hg.The rigid, nonexpandable cranium contains three components—brain tissue, blood, and cerebrospinal fluid (CSF)—that total ~1,700 mL in a typical adult: 1,400 mL brain (~80%), 150 mL blood (~10%), and 150 mL CSF (~10%). According to the Monro–Kellie doctrine, total intracranial volume is effectively fixed. When one component expands, CSF and venous blood...
Increased Intracranial Pressure ll: Pathophysiology
Increased intracranial pressure (ICP) refers to a potentially life-threatening rise in pressure inside the skull. This usually happens when there is a major change in the volume of brain tissue, blood, or cerebrospinal fluid (CSF) — the three components inside the skull. According to the Monro-Kellie doctrine, if the volume of one component increases, the volumes of the other components must decrease to maintain normal pressure. If this does not happen, ICP rises.The process often begins with...


