中国全科医学2017，Vol.20Issue(24)：3038-3042,5.DOI:10.3969/j.issn.1007-9572.2017.06.y37
肾上腺醛固酮-皮质醇共分泌瘤七例临床分析
Clinical Analysis of 7 Cases of Aldosterone-and Cortisol-producing Adenoma
林璐 1杨国庆 2吕朝晖 1窦京涛 1巴建明 1母义明 1金楠 1谷伟军 1杨丽娟 1臧丽 1杜锦 1陈康 1郭清华 1王先令1
作者信息
- 1. 100853北京市,中国人民解放军总医院内分泌科
- 2. 570311海南省海口市,海南省人民医院内分泌科
- 折叠
摘要
Abstract
Objective To retrospectively investigate the clinical features of 7 patients with aldosterone-and cortisol-producing adenoma(A/CPA) and reviewe the related literatures in order to improve the understanding and diagnosis and treatment of the disease.Methods The clinical data of 7 patients with A/CPA admitted to Chinese PLA General Hospital from 2010 to 2016 were retrospectively collected.The general situation,some general information,endocrine hormone levels,biochemical indexes,treatment and follow-up of A/CPA patients were summarized and analyzed.Results There were 1 male and 6 female in the 7 A/CPA patients,and the average age of visiting was(49.1±12.8)years old.The body mass index(BMI) was 21.5-28.5 kg/m2.The mean longest diameter of the adrenal adenomas was(3.4±1.6)cm.The plasma aldosterone level and plasma renin activity ratio(ARR) were measured in all 7 patients,and all of which were ≥25.The captopril challenge test and/or saline infusion test confirmed the diagnosis of primary aldosteronism(PA).All the patients had no clinical manifestations of typical Cushing′s syndrome and serum cortisol circadian rhythm disorder.And the results of overnight 1 mg dexamethasone suppression test or classic low-dose dexamethasone suppression test supported the diagnosis of subclinical Cushing′s syndrome.The postoperative pathological findings of 6 patients suggested adrenocortical adenoma.After surgery,2 patients presented symptoms of fatigue and anorexia.The plasma aldosterone and serum cortisol levels were reexamined in case 1 of the 2 patients and showed significantly reduced.The patinet was given prednisone replacement therapy for 5 months.Conclusion We should be aware of the possibility of merger of subclinical Cushing′s syndrome for APA patients with adrenal tumor diameter >2.0 cm.Preoperative measurement of relevant endocrine hormone levels should be completed to confirm the diagnosis.According to clinical symptoms and hormone levels to determine whether glucocorticoid replacement therapy is required after surgery.关键词
肾上腺疾病/醛固酮增多症/皮质醇/库欣综合征Key words
Adrenal gland diseases/Hyperaldosteronism/Cortisol/Cushing syndrome分类
医药卫生引用本文复制引用
林璐,杨国庆,吕朝晖,窦京涛,巴建明,母义明,金楠,谷伟军,杨丽娟,臧丽,杜锦,陈康,郭清华,王先令..肾上腺醛固酮-皮质醇共分泌瘤七例临床分析[J].中国全科医学,2017,20(24):3038-3042,5.
