论文部分内容阅读
目的:探讨库欣综合征的诊断方法及临床治疗体会。方法:选取在2011年4月到2014年4月来我院接受治疗的60例库欣综合征患者,对其临床资料进行回顾性分析,总结诊断方法提高诊断正确率,并对治疗方法进行分析。结果:主要采用的诊断方法为血浆皮质醇测定、24小时尿游离皮质醇测定(UFC)、小剂量地塞米松抑制试验,皮质醇昼夜节律消失的阳性率可达到91%,UFC升高的阳性率为93%,小剂量地塞米松抑制试验不被抑制率为75%;60例患者中行双侧肾上腺同时全切除术的有6例,同侧肾上腺全切加肾上腺肿瘤切除的有10例,同侧肾上腺部分切除加肾上腺肿块切除的有41例,3例行单侧肾上腺切除术。结论:诊断库欣综合征敏感性最高的指标是UFC升高和皮质醇昼夜节律的消失,手术是治疗库欣综合征的首选方法,疗效显著。
Objective: To explore the diagnosis of Cushing’s syndrome and clinical experience. Methods: Sixty patients with Cushing’s syndrome treated in our hospital from April 2011 to April 2014 were retrospectively analyzed, and the diagnostic methods were summarized to improve the diagnostic accuracy and the treatment methods were analyzed . Results: The main diagnostic methods used for the determination of plasma cortisol, 24-hour urinary free cortisol assay (UFC), low-dose dexamethasone inhibition test, the positive rate of cortisol disappearance of circadian rhythm can reach 91%, elevated positive UFC Rate of 93%, low-dose dexamethasone suppression test was not inhibited by 75%; 60 patients with bilateral total adrenalectomy in 6 cases, ipsilateral adrenalectomy plus adrenal tumor resection in 10 cases, There were 41 cases of ipsilateral adrenalectomy and adrenal resection, and 3 cases of unilateral adrenalectomy. Conclusion: The most sensitive indicator of Cushing’s syndrome is the increase of UFC and the disappearance of cortisol circadian rhythm. Surgery is the first choice to treat Cushing’s syndrome with significant curative effect.