| ES(empty sella) mainly makes reference to the herniation of the subarachnoid space within the sella turcica after the defect of the sella or the atrophy of the pituitary, leading to a series of clinical syndrome caused by normal pituitary gland tissue compression and the expansion of the sella.PES refers to the exclusion of the secondary factors such as trauma, surgery, radiotherapy, and the etiology has not been clear.Clinical manifestations such as headache, decreased vision, visual field damage effect produce in most of the people, some patients produce with pituitary deficiency.Studies have shown that pituitary deficiency is associated with increased risk of cardiovascular death(significantly higher incidence of cardiovascular events, case fatality rate is twice the normal people), so the comprehensive assessment of PES patients with cardiovascular disease risk,taking the necessary intervention and improving the patient's quality of life have an important significance for clinic.Objective: 1.Analyze the clinical data and the general situation of the PES patients.2. Analyze the difference between PES patients and normal control group in Framingham score and the other risk factors for cardiovascular disease.3. Analyze the difference between the patients with the normal pituitary function or the pituitary deficiency in Framingham score and the other risk factors for cardiovascular disease.4. Discuss the relationship between the lack of each hormone and the Framingham score or the other risk factors for cardiovascular disease.Methods: It is required to analyze the patients with PES in Cardio-Cerebrovascul ar Disease Hospital affiliated to Ningxia Medical University from January 2000 to July 2015, and provide complete clinical and laboratory data. Basing on its MRI imaging findings,diagnosis and exclusion criteria, a total of 77 patients were included in the study. A total of 67 patients have hormone levels measured, including 13 patients with normal pituitary function, 54 patients with pituitary deficiency. Healthy volunteers are selected from the patients with non-saddle lesions as normal control group(45 cases). For those who receive repeat treatment, it mainly focuses on the data of first treatment. Complete collection of data in the case group and the control group including: general situation(blood pressure, heart rate), age, gender, BMI, smoking status, hormone levels(pituitary-adrenal axis, pituitary-thyroid axis,pituitarysex axis),past medical history(diabetes, coronary heart disease, stroke, trauma, and saddle area lesion), SPSS21.0 software is also used for data statistics and data processing.Result: 1.male patients with a total of 22 people, accounts for about 28.6% than the women with a total of 55 people, accounting for about 71.4%.After 40 age, the number of patients increased significantly.2.the average BMI of all the patients is 24±3.4 kg/m2, of which 38 cases(49.4%) BMI < 24 kg/m2, 31 cases(40.3%) 24 kg/m2?BMI<28 kg/m2,8 cases(10.3%) BMI?28 kg/m2.3.the female patients with a history of 1 pregnancy(a total of 17 people) accounts for about 31%,with a history of two or more pregnancies( a total of 38 people) accounts for about 69% 4.5 patients show impaired thyroid function(7%),28 patients show hypogonadism(42%),37 patients show hypoadrenalism(55%)5. Framingham score, total cholesterol levels and heart rate has significant difference between patients and normal control group(P < 0.05).6.Framingham score and cardiovascular risk factors has no significant difference between pituitary normal group and hypopituitary patients(P > 0.05).7. the proportion of the high-risk groups and high blood pressure patients has a significant difference between normal adrenal function group and hypoadrenalism group(P < 0.05).8. the proportion of the high-risk groups and patients with diabetes,BMI, triglyceride, total cholesterol levels have a significant difference between normal group and hypogonadism group(P < 0.05).Conclusion: 1. PES patients are at higher risk of cardiovascular disease. It may be associated with the pituitary function decline in hormone levels leading to the glucose and lipid metabolism abnormality. 2. Hypoadrenalism patients have the lower Framingham score compared with the normal adrenal function patients. It may be associated with lower blood pressure in hypoadrenalism patients. 3. PES is more common in middle-aged women and obese patients. The history of pregnancy is considered as a risk factor for this disease, and the relationship between obesity and PES still hasn't been clear. 4. Even if PES patients have no pituitary function impairment, its hormone function defects may also lead to increase the risk of cardiovascular disease. |
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