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鉴别垂体依赖型和异位 ACTH 综合征颇为困难。本文作者对连续收治的 ACTH 依赖型柯兴综合征13例作双侧岩下窦取血测 ACTH,并讨论了与其他标准试验的诊断正确性和在鉴别诊断中的作用。柯兴综合征的诊断标准是24小时尿游离皮质醇增高,小剂量地塞米松不能抑制。用改良的 H_1导管插入两侧股静脉,右股静脉导管经左无名静脉进入左颈静脉球,左股静脉导管直接通过上腔静脉进入右颈静脉球,在 X 线监视下,导管尖部进入岩下窦,同时在两侧岩下窦及周围静脉各抽血5ml。结果在13例中,12例取血成功。几例患者诉插
Identification of pituitary-dependent and ectopic ACTH syndrome is difficult. The authors performed ACTH on bilateral inferior petrous sinus blood samples from 13 consecutive patients with ACTH-dependent Cushing syndrome, and discussed the diagnostic accuracy with other standard tests and their role in differential diagnosis. The diagnostic criteria for Cushing’s syndrome are increased 24-hour urinary free cortisol, and low-dose dexamethasone cannot be suppressed. With a modified H_1 catheter inserted into the femoral veins on both sides, the right femoral vein catheter enters the left jugular vein via the left innominate vein. The left femoral vein catheter enters the right jugular vein directly through the superior vena cava. Under the X-ray monitoring, the tip of the catheter enters The inferior petrous sinus, at the same time, draws 5 ml of blood from the inferior sinus and surrounding veins on both sides. Results In 13 cases, 12 cases were successful. Several patients v.