Researches On The Pituitary Endocrine Function In Patients With Resection Of Pituitary Adenoma For At Least 3 Months

Background: pituitary adenoma is a common kind of intracranial benign endocrine tumor, besides secreting too much hormones of pituitary gland which induce metabolic disorders and damages to the target organs, the pituitary adenoma can also induce mechanical compression to the normal pituitary tissues and decrease the secretion of the other pituitary hormones, then result in the damages to the corresponding target glands, the non functioning pituitary adenoma can not secret pituitary hormone, but can induce the compression to the pituitary adenoma and decrease the secretion of the pituitary hormone. The main treatment of the pituitary adenoma is surgical resection except the drug treatment in prolactinoma. However, although the surgical resection of the adenoma release the mechanical compression of the tumor, at the same time, the operation damage the normal pituitary tissues, then decrease the section of all kinds of pituitary hormone and influence the function of the target gland. Both the pituitary tumor and operation of the pituitary gland can induce anterior hypopituita, especially in male patients. For now, there are few researches about the pituitary secreting function in patients who have received the pituitary tumor resection operation for at least 3 months. so, we select 29 patients who have received the pituitary prolactinoma and non functioning adenoma resection operation for at least 3 months from 200 patients who have received pituitary adenoma resection operation, then detect the level of the pituitary hormone and research the changes of the hormone corresponding to the time.Objective:detect the pituitary endocrine function of the patients who have received the pituitary tumor resection operation for at least 3 months. Analyze the effect to the patients` endocrine function caused by the tumor and resection operation, evaluate the pituitary function of the patients have received the pituitary adenoma resection operation, then direct the treatment of the patients after operation.Methods:Select 29 patients who have received the pituitary prolactinoma and non functioning adenoma resection operation for at least 3 months, exclude the patients who have suffered cancer, diabetes, hypertension, mental illnesses and severe hepatic or renal dysfunction.there are 29 patients who have received the resection of the pituitary prolactinoma or non functional adenoma for at least 3 months. Then divide the patients into 9 teams according to the time after operation. Measure the levels of the patients` ACTH, TSH, GH and sex hormone, evaluate the level of the patients` pituitary hormone after the pituitary adenoma operation, average the level of the patients` hormones in each team. use these data to do line chart, analyze the changes of the patients` each kind of the hormone corresponding to the time.Research Results:The level of the GH in 96.55% of the patients who have received the pituitary adenoma resection operation is lower than normal, the level of the TSH in 65.52% of the patients is lower. The testosterone level in 20% of male patients is lower, the ACTH level in 10.34% of patients is lower than normal.82.76% of the patients` ACTH level is lower than 40pg/ml,44.83% of the patients` ACTH level is lower than 20pg/ml. Some patients have the manifestations of hypopituitarism, for example, asthenia, osteoporosis, xerosiscutis, trichomadesis and Sexual dysfunction. Except the ACTH, the levels of the rest pituitary hormone in patients who have received the adenoma resection operation for 4 to 6 months are all low, but have a increasing tendency, corresponding to the time after operation, the levels of the GH reach a peak at 13 to 15 months after operation, the levels of the TSH reach a peak at 16 to 18 months after operation, the levels of the testosterone in male patients reach a peak at 25 to 27 months. After reaching a peak, the hormones in patients then decrease.Conclusion:The pituitary adenoma compress the normal pituitary tissue, then influence the secretion of the related hormone. The resection operation can release the compression of the tumor, however, the operation can also damage the normal tissue to a certain extent at the same time. So after the tumor resection operation, the level of the pituitary hormone are all in a low level, then the pituitary function recover as time goes on. The levels of the hormones increase and then reach a peak. The function of the pituitary gland gonadal axis recover in the last, the peak of the testosterone in male patients appears last. However, the pituitary function then decrease again as time goes on. The levels of the hormones in patients who have received the pituitary adenoma operation are lower than normal because of the damages to the normal tissues caused by the operation especially the GH.