The Effcet Of Growth Hormone Replacement In Patients Wiyh Sheenhan’s Syndrome

Objective This article aims at summarizing the achievements of effectof growth hormone replacement in the patients with Sheehan’s syndrome，hoping to be conductive to the scientific research and clinical work forresearch workers in this field and abroad.Background Data Sheehan’s syndrome is characterized by variousdegrees of hypopituitarism and secondary hormone deficiency, anddevelops as a result of ischemic pituitary necrosis due to severe postpartumhemorrhage. It is one of the resources of adult growth hormone deficiency.There are loads of researches demonstrated the influence thatrecombination growth hormone treatment would induce in adults withgrowth hormone deficiency, and come to controversial results. Accordingto different physiopathologic process from hypothalamus-pituitarium tumorand their treatments, empty sella tarcica syndrome, cranium trauma,pituitary lymphocytes inflammation, idiopathic growth hormone deficiencyand other diseases that cause growth hormone deficiency, patients withSheehan’s syndrome might go through different characteristics and severity of hormone deficient compared to the other diseases, which might lead tovaried treatment responses. Sheehan’s syndrome may lead to isolatedhormone deficiency or total pituitary deficiency，the most common simplehormone deficiency is growth hormone deficiency and the most frequentand earliest endocrine disorders in total pituitary deficiency are thedeficiencies of growth hormone and prolactin. The patients with Sheehan’ssyndrome suffered from severe and long-term growth hormone deficiency.Due to apparent characteristics of hormone deficiencies in patients withSheehan’s syndrome, it is important to clarify the treatment responses resultfrom growth hormone replacement.Methods Review literatures, summarize the clinical effect of growthhormone replacement in patients with Sheehan’s syndrome.Results Growth hormone replacement reverses anthropometricparameters， body composition， lipid metabolism， cardiovascularparameters，cognition function，quality of life，skin characteristics ofpatients with Sheehan’s syndrome. It exerts similar effects with adultsgrowth hormone deficiency in lean body mass，visceral fat，cardiovascularparameters，sleep architecture. According to controversial results in adultswith growth hormone deficiency in aspects of anthropometricparameters，lipid and glucose metabolism, growth hormone replacementresult in decreases in elevated waist circumference, waist/hip ratio，serumlevel of low density lipoprotein，total cholesterol and increases in reduced serum level of high density lipoprotein. Although growth hormonereplacement may rise serum level of insulin, it doesn’t elevate bloodglucose and glycosylated hemoglobin in long term utilization, which mightlead to bigger cost-effectiveness and smaller adverse events. Nevertheless,what will happen to posterior pituitary function, bone parameters, drugadverse events of growth hormone replacement still need further studies toclarify. Effects of growth hormone replacement on serum cortisol inpatients with Sheehan’s syndrome,whether reexamination of serum cortisoland modification of doses of oral glucocorticoid is needed still need furtherinvestigation.Conclusion Sheehan’s syndrome is characterized by long-term andsevere growth hormone deficiency. Growth hormone replacement exertsbenefit effects on cardiovascular parameters，cognition function，quality oflife，skin characteristics in patients with Sheehan’s syndrome.