儿童鞍区肿瘤术后垂体功能减退合并非酒精性脂肪性肝病的临床特征分析
目的 总结儿童鞍区肿瘤术后垂体功能减退合并非酒精性脂肪性肝病(NAFLD)的临床特征，探索儿童垂体功能减退与NAFLD之间的临床联系。 方法 回顾性分析2017年1月—2021年12月于华中科技大学同济医学院附属武汉儿童医院规律随访的鞍区肿瘤术后垂体功能减退出现NAFLD的患儿临床资料，分析临床特点。 结果 共32例规律随访且临床资料完整的鞍区肿瘤术后患者，其中10例(31.25%)出现NAFLD，其中男5例，女5例，9例为颅咽管瘤，均手术治疗，1例为生殖细胞瘤，局部放射治疗。10例患儿诊断垂体功能减退时的中位年龄为8.4(6.2~9.8)岁；诊断NAFLD的中位年龄为11.9(8.7~12....
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| Published in | Linchuang gandanbing zazhi Vol. 39; no. 6; pp. 1332 - 1339 |
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| Main Authors | , , , , , , , , |
| Format | Journal Article |
| Language | Chinese |
| Published |
Changchun
Journal of Clinical Hepatology
01.06.2023
华中科技大学同济医学院附属武汉儿童医院遗传代谢内分泌科,武汉 430015 |
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| Online Access | Get full text |
| ISSN | 1001-5256 2097-3497 |
| DOI | 10.3969/j.issn.1001-5256.2023.06.013 |
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| Abstract | 目的 总结儿童鞍区肿瘤术后垂体功能减退合并非酒精性脂肪性肝病(NAFLD)的临床特征，探索儿童垂体功能减退与NAFLD之间的临床联系。 方法 回顾性分析2017年1月—2021年12月于华中科技大学同济医学院附属武汉儿童医院规律随访的鞍区肿瘤术后垂体功能减退出现NAFLD的患儿临床资料，分析临床特点。 结果 共32例规律随访且临床资料完整的鞍区肿瘤术后患者，其中10例(31.25%)出现NAFLD，其中男5例，女5例，9例为颅咽管瘤，均手术治疗，1例为生殖细胞瘤，局部放射治疗。10例患儿诊断垂体功能减退时的中位年龄为8.4(6.2~9.8)岁；诊断NAFLD的中位年龄为11.9(8.7~12.6)岁。从诊断垂体功能减退至诊断NAFLD的中位年数为2.0(1.4~4.0)年。诊断NAFLD时，10例患者均为肥胖，BMI较诊断垂体功能减退时平均增加(7.26±4.25)kg/m2；10例患者空腹血糖均正常，平均为(4.67±0.55)mmol/L，平均空腹胰岛素水平为(25.40±5.93)μIU/mL；胰岛素抵抗指数(HOMA-IR)平均为(5.26±1.29)；9例患者有高甘油三酯血症，1例患者甘油三酯升高，平均为(3.08±1.09)mmol/L；6例患者有高胆固醇血症，平均为(5.67±1.25)mmol/L；8例患者有高低密度脂蛋白胆固醇血症，平均为(3.97±1.27)mmol/L。2例患者诊断NAFLD予重组人生长激素联合二甲双胍治疗，治疗后患儿BMI、HOMA-IR及甘油三酯均较治疗前下降，总胆固醇、低密度脂蛋白胆固醇均降至正常范围。 结论 鞍区肿瘤术后患儿可出现体质量增加及垂体功能减退，继而出现胰岛素抵抗及血脂异常，从而导致NAFLD的发生。对这类患儿应进行体质量管理和积极的垂体激素替代治疗，并予以常规的脂肪肝相关筛查和管理。 |
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| AbstractList | 目的 总结儿童鞍区肿瘤术后垂体功能减退合并非酒精性脂肪性肝病(NAFLD)的临床特征，探索儿童垂体功能减退与NAFLD之间的临床联系。 方法 回顾性分析2017年1月—2021年12月于华中科技大学同济医学院附属武汉儿童医院规律随访的鞍区肿瘤术后垂体功能减退出现NAFLD的患儿临床资料，分析临床特点。 结果 共32例规律随访且临床资料完整的鞍区肿瘤术后患者，其中10例(31.25%)出现NAFLD，其中男5例，女5例，9例为颅咽管瘤，均手术治疗，1例为生殖细胞瘤，局部放射治疗。10例患儿诊断垂体功能减退时的中位年龄为8.4(6.2~9.8)岁；诊断NAFLD的中位年龄为11.9(8.7~12.6)岁。从诊断垂体功能减退至诊断NAFLD的中位年数为2.0(1.4~4.0)年。诊断NAFLD时，10例患者均为肥胖，BMI较诊断垂体功能减退时平均增加(7.26±4.25)kg/m2；10例患者空腹血糖均正常，平均为(4.67±0.55)mmol/L，平均空腹胰岛素水平为(25.40±5.93)μIU/mL；胰岛素抵抗指数(HOMA-IR)平均为(5.26±1.29)；9例患者有高甘油三酯血症，1例患者甘油三酯升高，平均为(3.08±1.09)mmol/L；6例患者有高胆固醇血症，平均为(5.67±1.25)mmol/L；8例患者有高低密度脂蛋白胆固醇血症，平均为(3.97±1.27)mmol/L。2例患者诊断NAFLD予重组人生长激素联合二甲双胍治疗，治疗后患儿BMI、HOMA-IR及甘油三酯均较治疗前下降，总胆固醇、低密度脂蛋白胆固醇均降至正常范围。 结论 鞍区肿瘤术后患儿可出现体质量增加及垂体功能减退，继而出现胰岛素抵抗及血脂异常，从而导致NAFLD的发生。对这类患儿应进行体质量管理和积极的垂体激素替代治疗，并予以常规的脂肪肝相关筛查和管理。 目的 总结儿童鞍区肿瘤术后垂体功能减退合并非酒精性脂肪性肝病(NAFLD)的临床特征,探索儿童垂体功能减退与NAFLD之间的临床联系.方法 回顾性分析2017 年1 月—2021 年 12 月于华中科技大学同济医学院附属武汉儿童医院规律随访的鞍区肿瘤术后垂体功能减退出现NAFLD的患儿临床资料,分析临床特点.结果 共 32 例规律随访且临床资料完整的鞍区肿瘤术后患者,其中10 例(31.25%)出现NAFLD,其中男5 例,女5 例,9 例为颅咽管瘤,均手术治疗,1 例为生殖细胞瘤,局部放射治疗.10 例患儿诊断垂体功能减退时的中位年龄为8.4(6.2～9.8)岁;诊断NAFLD的中位年龄为11.9(8.7～12.6)岁.从诊断垂体功能减退至诊断NAFLD的中位年数为2.0(1.4～4.0)年.诊断NAFLD时,10 例患者均为肥胖,BMI较诊断垂体功能减退时平均增加(7.26±4.25)kg/m2;10 例患者空腹血糖均正常,平均为(4.67±0.55)mmol/L,平均空腹胰岛素水平为(25.40±5.93)μIU/mL;胰岛素抵抗指数(HOMA-IR)平均为(5.26±1.29);9 例患者有高甘油三酯血症,1 例患者甘油三酯升高,平均为(3.08±1.09)mmol/L;6 例患者有高胆固醇血症,平均为(5.67±1.25)mmol/L;8 例患者有高低密度脂蛋白胆固醇血症,平均为(3.97±1.27)mmol/L.2 例患者诊断NAFLD予重组人生长激素联合二甲双胍治疗,治疗后患儿BMI、HOMA-IR及甘油三酯均较治疗前下降,总胆固醇、低密度脂蛋白胆固醇均降至正常范围.结论 鞍区肿瘤术后患儿可出现体质量增加及垂体功能减退,继而出现胰岛素抵抗及血脂异常,从而导致NAFLD的发生.对这类患儿应进行体质量管理和积极的垂体激素替代治疗,并予以常规的脂肪肝相关筛查和管理. |
| Author | 杜婷婷 姚辉 杨禄红 丰利芳 陈晓红 罗杰 罗娟 胡曼 陈晓倩 |
| AuthorAffiliation | 华中科技大学同济医学院附属武汉儿童医院遗传代谢内分泌科,武汉 430015 |
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| Author_FL | LUO Jie LUO Juan YANG Luhong CHEN Xiaoqian FENG Lifang DU Tingting YAO Hui CHEN Xiaohong HU Man |
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| Keywords | 垂体功能减退症 非酒精性脂肪性肝病 儿童 体征和症状 |
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| PublicationTitle_FL | Journal of Clinical Hepatology |
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| Publisher | Journal of Clinical Hepatology 华中科技大学同济医学院附属武汉儿童医院遗传代谢内分泌科,武汉 430015 |
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| Snippet | 目的 总结儿童鞍区肿瘤术后垂体功能减退合并非酒精性脂肪性肝病(NAFLD)的临床特征，探索儿童垂体功能减退与NAFLD之间的临床联系。 方法 回顾性分析2017年1月—2021年12月于... 目的 总结儿童鞍区肿瘤术后垂体功能减退合并非酒精性脂肪性肝病(NAFLD)的临床特征,探索儿童垂体功能减退与NAFLD之间的临床联系.方法 回顾性分析2017 年1 月—2021 年 12 月... |
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| SubjectTerms | Body mass index Endocrine disorders Fatty liver Hormone replacement therapy Liver diseases Surgery |
| Title | 儿童鞍区肿瘤术后垂体功能减退合并非酒精性脂肪性肝病的临床特征分析 |
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