| Background and Objective: It is found that some patients visit to the Department of Gastroenterology with the symptoms of nausea,vomiting,bloating and loss of appetite and so on.However,the symptoms can't be alleviate or even became serious after symptomatic treatment.The doctor found that the causes of the symptoms are not diseases of digestive tract but pituitary lesions after a serious examination.Moreover,it's easier to occur in elderly people than younger patients and most of the diseases have hypopituitarism.Along with people getting older,fibrosis and vascular insufficiency occur in pituitary,which influence function of pituitary.It's easily to attribute the symptoms of hypopituitarism to physiological changes.In addition,it is hard to diagnosed because of multi-system organ deseases,which can hide the primary clinical symptoms of hypopituitarism.Besides,the clinicians' lack of cognition of hypopituitarism delays the diagnosis.With the increasing proportion of the elderly,such case of delaying diagnosis may increase.Some domestic studies have analyzed the characteristics of hypopituitarism,but few analyzed the causes which resulted in gastrointestinal symptoms and matters needed be noticed during diagnosis of hypopituitarism,especially for the elderly.The research studied case characteristics and the factors related to gastrointestinal symptoms of 23 elderly patients of hypopituitarism with gastrointestinal symptoms.The aim of this paper was to remind clinicians to make correct diagnosis and shorten treatment time as soon as possible facing this kind ofpatients.Methods: The patients who were diagnosed of pituitary lesions from the first Hospital Affiliated to Dalian Medical University from 2004 to 2014 were retrospectively collected.Cases of hypopituitarism with complete clinical data who were over 60 years old were selected.All cases were diagnosed again by reference of Clinical Endocrinology with the exception of serious cardiovascular disease,other primary endocrine diseases and active digestive diseases.Divided the cases into two groups according to accompanied with gastrointestinal symptoms or not.Group G had gastrointestinal symptoms and Group N didn't have gastrointestinal symptoms.The cases of Group G were analyzed in several aspects,including sex,symptom types,abdomen positive signs,the cause of hypopituitarism,electrolyte disturbance,low lactation hyperprolactinemia,growth hormone deficiency and target gland axis dysfunction incidence.The indexes related to gastrointestinal symptoms were made statistical analysis between group G and group N.SPSS19.0 statistical software was used for analysis processing of above experimental data.(x±s)and t test was used for measurement data;chi square test was used for counting data for difference test.If p <0.05,the difference was statistically significant.Results:1.The sex ratio had no obvious difference in group G(P>0.05).In group G,there were about 69.57% with nausea and vomiting,followed by abdominal distension and loss of appetite.None of group G had abdominal positive signs.The first cause of hypopituitarism in group G was pituitary tumor.The proportion of hyponatremia was about 78.26% and the proportion of secondary adrenocortical hypofunction was about65.97%.3.Data of statistical analysis between of group G and group N suggested that the indexes of sodium and cortisol were statistically significant(P<0.05)and other laboratory indicators had no difference(P>0.05).Average value of sodium and cortisol were compared between the two groups,suggested the values of group G was lower than group N.Conclusion:1.It's alerted to think that whether to diagnose hypopituitarism for elderly patients with gastrointestinal symptoms when routine auxiliary examination ofthe digestive tract haven't found abnormal.2.Elderly patients with gastrointestinal symptoms accompanied by decreased serum sodium and serum cortisol levels should be distinguish with hypopituitarism. |
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