Objective To investigate changes of relative
pituitary hormones in
adults with
traumatic brain injury (TBI) and the related
clinical significance.
Methods Quantitative analysis and dynamic
observation of relative
pituitary hormones were performed in 158 TBI
patients by electrochemical
luminescence method.Measured indices included
plasma total
cortisol (PTC),free
triiodothyronine (lT3),free
thyroxine (FT4),
thyrotropin (TSH),
growth hormone,
follicle stimulating hormone (FSH),
luteinizing hormone (LH),
estradiol,
testosterone,and
prolactin.Results
Prolactin and PTC increased in the acute phase,but gradually reduced three days after
trauma.TSH,FT3,and FT4 slightly decreased after
trauma,followed by a gradual return.While there were no significant changes in FSH,LH,
estradiol,
testosterone,and
growth hormone after
trauma.Changes in relative
pituitary hormones were more profound in
patients with a lower GCS.Some
patients presented different degree of reduced
hormones in recovery period and needed
hormone replacement therapy.Among the
patients with poor activity of daily living (
ADL),lvothyroxine replacement
therapy was applied in 2
patients (2/6),
prednisone acetate in 1 (1/6),and eleven
acid testosterone in 2 (2/6).Among
patients with mild
ADL,levothyroxine replacement
therapy was applied in 2
patients (11%),
prednisone acetate in 1 (6%),and eleven
acid testosterone in 3 (17%).Among
patients with good
ADL,levothyroxine replacement
therapy was applied in 2
patients (4%) and eleven
acid testosterone in 3 (6%).Persistent
prolactin elevation was found in
patients with poor outcome.Conclusions Changes of relative
pituitary hormones in
adult patients with TBI are associated with severity and duration of
trauma.Abnormal
prolactin level can
affect outcome of the
patients.