ABSTRACT
Objective To explore changes of blood anterior pituitary hormone and its related factors in patients with severe traumatic brain injury (TBI).Methods 113 patients diagnosed as severe TBI and met criterions were collected from Jun.2010 to Aug.2015 in the First Affiliated Hospital of Wenzhou Medical University.Clinical data such as age,gender,site of injury,epidural hematoma,subdural hematoma,basicranial fracture,injury time,Glasgow coma scale (GCS),middle line migration,diffuse axonal injury,brain hernia,traumatic subarachnoid hemorrhage were collected and recorded.Univariatex2 test and multivariate logistic regression analysis were used to explore risk factors for changes of blood anterior pituitary hormone.Results Abnormal secretion of the anterior pituitary occurred in 48 patients.10 cases had one kind of abnormal hormone secretion,while 38 cases had 2 and more than 2 kinds of abnormal hormone secretion.GH level decreased in 20 cases,TSH level decreased in 18 cases,FSH level decreased in 12 cases,PRL level increased in 10 cases,ACTH level decreased in 9 cases,and LH level decreased in 8 cases.Univariate x2 test revealed that basicranial fracture (P=0.006),middle line migration (P=0.007),GCS score (P=0.004),diffuse axonal injury (P=0.001),cerebral hernia (P=0.001),traumatic subarachnoid hemorrhage (P=0.001) were factors related to abnormal pituitary hormone levels.Multivariate logistic regression analysis revealed that basicranial fracture (P=0.019),middle line migration (P=0.015),GCS score (P=0.024),diffuse axonal injury (P=0.008),cerebral hernia (P=0.001),traumatic subarachnoid (P=0.010) were factors related to abnormal pituitary hormone levels.Conclusions The rates of abnormal pituitary hormone level were higher in patients with severe TBI.The basicranial fracture,middle line migration,GCS score,diffuse axonal injury,cerebral hernia,traumatic subarachnoid hemorrhage are factors related to abnormal pituitary hormone levels.