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目的 通过对经手术后病理证实的 16 2例库欣综合征患者临床资料的分析 ,进一步认识类固醇性糖尿病的特点。方法 回顾性分析库欣患者的发病年龄 ,库欣病程 ,体重指数 (BMI) ,2 4h尿游离皮质醇浓度 (2 4hUFC) ,病理结果 ,手术前后空腹血糖水平 ,糖尿病家族史 ,术前及术后糖代谢异常的治疗等。结果 患有继发糖尿病的库欣患者发病年龄及库欣病程明显高于血糖正常组。而 BMI与 2 4h UFC两组患者差异无显著意义。除肾上腺癌外两组病理类型差异无显著意义。糖代谢异常患者术后空腹血糖水平明显低于术前。术后大部分糖尿病患者停用了药物治疗。仅一例继发糖尿病患者家族史阳性。结论 高龄发病及病程长的库欣患者易出现糖代谢异常 ,糖尿病家族史、向心性肥胖、尿皮质醇水平及库欣的良性病理类型似与发生糖代谢异常无关。继发性糖尿病的治疗重点应是原发病的根治。
Objective To further understand the characteristics of steroid-induced diabetes by analyzing the clinical data of 162 Cushing’s syndrome patients confirmed by pathology. Methods The age of onset, Cushing’s disease course, body mass index (BMI), 24 h urinary free cortisol concentration (24 h UFC), pathological findings, fasting blood glucose level before and after surgery, family history of diabetes, preoperative and postoperative Treatment of abnormal glucose metabolism. Results The age of onset and Cushing’s disease duration of Cushing patients with secondary diabetes were significantly higher than those of normal blood glucose group. There was no significant difference between BMI and 24 h UFC patients. In addition to adrenal cancer pathological types outside the two groups no significant difference. Patients with abnormal glucose metabolism postoperative fasting blood glucose levels were significantly lower than preoperative. Most patients with diabetes after the withdrawal of drug treatment. Only one case of secondary diabetic family history was positive. CONCLUSIONS: Elderly patients with Cushing onset and long course of disease are prone to abnormal glucose metabolism. Family history of diabetes mellitus, central obesity, urinary cortisol levels and benign pathological types of Cushing may not be related to abnormal glucose metabolism. The treatment of secondary diabetes should focus on the cure of the primary disease.