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目的总结住院空蝶鞍综合征(ESS)患者的主要病因、危险因素、临床特征及垂体功能改变。方法回顾分析2001年1月至2012年12月期间收治的48例ESS患者临床资料。结果 (1)男性占35.4%(17/48),女性占64.6%(31/48),原发性占81.3%(39/48),继发性占18.8%(9/48)。原发性中女性患者26例(66.7%,26/39),有妊娠史的占76.9%(20/26),多胎妊娠占42.3%(11/26);77.8%(7/9)的继发性ESS与垂体肿瘤的治疗相关。(2)本组住院患者常见主诉包括头痛(33.3%)、恶心呕吐(20.8%)、视力障碍(18.8%)等,其中视力障碍在继发性ESS相对多见(44.4%,4/9)。(3)完整评估垂体-靶腺功能的25例患者中,腺垂体功能减退占40%(10/25)。垂体功能减退发生率在原发性与继发性(38.9%vs.42.9%,P>0.05)和完全性与部分性(33.3%vs.43.8%,P>0.05)中均无显著差异。结论本组住院患者以原发性ESS常见,有多次妊娠史的中年女性罹患原发性ESS的风险更高;视力障碍在继发性ESS更为多见。腺垂体功能减退在原发性和继发性、完全性和部分性之间未见显著差异,提示ESS患者无论其空蝶鞍发生原因及程度如何都应定期评估腺垂体激素功能。
Objective To summarize the main causes, risk factors, clinical features and changes of pituitary function in hospitalized patients with empty sella syndrome (ESS). Methods The clinical data of 48 patients with ESS admitted from January 2001 to December 2012 were retrospectively analyzed. Results (1) Male accounted for 35.4% (17/48), female accounted for 64.6% (31/48), primary accounted for 81.3% (39/48), secondary accounted for 18.8% (9/48). Among them, 26 (66.7%, 26/39) had primary women, 76.9% (20/26) had pregnancy history, 42.3% (11/26) had multiple pregnancy, 77.8% (7/9) succeeded ESS is associated with the treatment of pituitary tumors. (2) The common complaints of inpatients included headache (33.3%), nausea and vomiting (20.8%), visual impairment (18.8%) and so on. Among them, visual impairment was relatively common in secondary ESS (44.4%, 4/9) . (3) Among the 25 patients with complete assessment of pituitary-target gland function, the hypopituitarism accounted for 40% (10/25). The incidence of pituitary dysfunction in primary and secondary (38.9% vs.42.9%, P> 0.05) and complete and partial (33.3% vs.43.8%, P> 0.05) no significant difference. Conclusions Middle-aged women with common primary ESS and multiple pregnancies in this group of hospitalized patients have a higher risk of developing primary ESS; visual impairment is more common in secondary ESS. Adenor pituitary dysfunction in primary and secondary, complete and partial no significant difference between, suggesting that ESS patients, regardless of their empty sella saddle occurrence and extent should be regularly assessed pituitary hormone function.