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作者报告了第一例妊娠合并肾上腺皮质腺瘤造成的柯兴氏综合征。患者于孕中期基于临床症征及血、尿皮质激素变化——尿17-酮,17-羟皮质类固醇增高;血浆皮质醇正常但缺乏日间差异;午夜服用地赛米松后8小时血浆皮质醇水平未呈现抑制反应——而诊为柯兴氏综合征。腹部及盆腔超声图显示肾上腺区正常。至孕晚期临床表现显著改善,血、尿皮质醇、尿17-酮、17-羟皮质类固醇逐渐减少至低于正常,ACTH在产前明显增高,血清胎盘生乳麦正常增长,尿雌三醇未升至1.0mg/日。于孕38周因胎儿窘迫而行剖腹产。术中检查卵巢正常,触诊双侧肾上腺区无肿物。新生儿未伴有垂体及肾上腺功能不
The authors report the first case of Cushing’s syndrome caused by pregnancy associated with adrenocortical adenoma. Patients in the second trimester of pregnancy based on clinical signs and changes in blood and urine levels of corticosteroids - urinary 17-ketone, 17-hydroxy corticosteroids increased plasma cortisol normal but lack of day-to-day differences; midnight dose of dexamethasone 8 hours after plasma cortisol Level did not show inhibitory response - and diagnosed as Cushing’s syndrome. Abdominal and pelvic ultrasound showed normal adrenal gland area. Clinical manifestations improved significantly in the third trimester of pregnancy. Serum and urinary cortisol, urinary 17-keto-17-hydroxycorticosteroids gradually decreased to below normal, ACTH was significantly elevated in the prenatal period, normal serum in the placenta increased, Rose to 1.0mg / day. 38 weeks pregnant due to fetal distress and caesarean section. Intraoperative examination of normal ovary, palpation of bilateral adrenal area without mass. Neonatal without pituitary and adrenal function is not