摘要
目的 探讨肾上腺意外瘤中亚临床库欣综合征患者的临床转归。方法 随访我院诊治的37例亚临床库欣患者的临床和实验室检查资料。结果 本组随访亚临床库欣患者中8．11％（3／37）发展为临床显性库欣。患者有代谢综合征的临床症状，在随访1～3年后出现显性库欣综合征的典型临床症状，血尿皮质醇升高，2mg和8mg地塞米松抑制试验不能抑制，患者行肾上腺腺瘤摘除术后临床症状改善，糖皮质激素水平降低。结论 亚临床库欣患者有部分可发展成为临床显性库欣，对肾上腺意外瘤患者应仔细行生化指标和激素水平检查，明确其功能，一经确诊为亚临床库欣，应积极手术。
Objective To study the natural course of subclinical Cushing＇ s syndrome in patients with adrenal incidentalomas. Methods We underwent follow-ups of 37 consecutive patients with subclinical Cushing＇ s syndrome in adrenal incidentalomas. Results Of all patients with a follow-up of at least 6 months, three developed into overt Cushing＇ s syndrome in 1 to 3 years. All of them had some signs of metabolic syndrome at diagnosis. After 1 to 3 years of follow-up, they showed clinical features of overt Cushing＇ s syndrome. The plasma and urinary cortisol were elevated, and the plasma cortisol did not respond to 2 and 8 mg dexamethasone suppression test. The patients underwent open adrenalectomy. After surgery, they showed regression of Cushing＇ s features and glucocorticoid secretion. Conclusion Patients with subclinical Cushing＇s syndrome may develop into overt Cushing＇s syndrome. Therefore, a careful biochemical and hormonal follow-up is advisable in patients with adrenal incidentalomas. The potential benefit of adrenalectomy should be considered in those who have a definite diagnosis of subclinical Cushing＇s syndrome.
出处
《上海交通大学学报（医学版）》
CAS
CSCD
北大核心
2006年第1期37-39,共3页
Journal of Shanghai Jiao tong University:Medical Science
基金
上海市教委重点学科基金(Y0204)资助项目
关键词
亚临床库欣
肾上腺意外瘤
显性库欣综合征
subclinical Cushing＇s syndrome
adrenal incidentaloma
overt Cushing＇s syndrome
