（参考翻译）02.2Hypopituitarism大课课件.pptVIP

Investigation 调查 1、Measurement of hormones 2 、Stimulating test Investigation 1、Measurement of hormones level pituitary hormones target glands hormones PRL GH GnRH(LH、FSH) E2、T TSH T3、T4 ACTH Cortisone hypopituitarism normal range 2 、 Stimulating test： 1）assess pituitary function 2) assess target gland function 1) Assessment of the functions of pituitary GHRH or CRF 促皮质素释放因子or LHRH is injecting into human’s body, then measure the level of pituitary hormones and target gland hormones. Hormone from hypothalamus Hormone from pituitary gland GHRH GH CRF ACTH LHRH LH、FSH Can not be elevated Hormone from pituitary gland Target gland hormones ACTH cortisone TSH T3、T4 2) Assessment of the function of target glands Insulin-hypoglycemia 低血糖 stimulating test insulin injection to induce hypoglycemia cortisone Adrenal gland 3、others Hypoglycemia 低血糖 Hypotension 低血压 Hyposalemia(低钠血症) Anemia（贫血） 4、Imageological examination（影像学检测） CT or MRI X-ray Diagnosis 1)history of damage to pituitary gland or hypothalamus 2)symptoms and signs related to hormone deficiency 3) evidency of anterior pituitary hormone deficiency Treatment Hormone replacement All life replacement 1、Adrenal hormone replacement must be first Hydrocortisone 20mg 8AM 10mg 4PM Cortisone 5mg 8AM 2.5mg 4PM Fludrocortisone 氟氢可的松 may be not required if necessary 0.1-0.2mg/d Goal: No symptoms and signs due to adrenal gland hormone deficiency. No symptoms and signs of due to adrenal gland hormone overdose 过量. 2、Thyroid hormone replacement L-T4 original dose 12.5-25ug/d maintenance dose 100-200ug/d 3、Sexal hormone Replacement For people in reproductive age or anxiety for fertility Estrgen (雌激素)