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联合法与经典法地塞米松抑制试验诊断Cushing综合征价值的比较
引用本文:卢琳,曾正陪,陶红,顾锋,李梅,李玉秀,付勇,童安莉,周亚茹,张晶,陈适,梁伟,陆召麟. 联合法与经典法地塞米松抑制试验诊断Cushing综合征价值的比较[J]. 中国实用内科杂志, 2006, 26(22): 1784-1787
作者姓名:卢琳  曾正陪  陶红  顾锋  李梅  李玉秀  付勇  童安莉  周亚茹  张晶  陈适  梁伟  陆召麟
作者单位:中国医学科学院中国协和医科大学北京协和医院内分泌科,北京,100730
摘    要:
目的评价联合法及经典法小及大剂量地塞米松抑制试验(DST)诊断Cushing综合征的价值。方法回顾性分析北京协和医院1997—2006年152例经手术病理证实的Cushing综合征病例,将经典法与联合法小及大剂量DST结果与病理诊断结果相比较。结果过夜小剂量DST、经典小剂量DST和联合法之小剂量DST对Cushing综合征定性诊断的符合率分别为97.5%、96.1%和97.6%。3组之间差异无统计学意义(P=0.86)。经典大剂量、联合法之大剂量DST对Cushing病诊断的符合率分别为80.6%、76.4%,2组之间差异无统计学意义(P=0.73)。经典大剂量、联合法之大剂量DST对肾上腺皮质激素(ACTH)非依赖性Cushing综合征诊断的符合率分别为94.2%和95.5%,2组之间差异无统计学意义(P=0.83)。经典法分别行小及大剂量和联合法小及大剂量DST诊断Cushing病的敏感性分别为81.5%和77.8%,特异性分别为92.5%和95.5%。结论联合法小及大剂量DST比经典法分别行小及大剂量DST操作简便,节省时间,对照值更加准确,2种方法对诊断的符合率差异没有统计学意义,联合法小及大剂量DST可用于Cushing综合征的定性、定位诊断。

关 键 词:Cushing综合征  地塞米松抑制试验
文章编号:1005-2194(2006)22-1784-04
修稿时间:2006-08-27

Comparison of effects between the combined and classic dexamethasone suppression test on diagnosis of Cushing''''s syndrome
Lu Lin,Zeng Zhengpei,Tao Hong,et al.. Comparison of effects between the combined and classic dexamethasone suppression test on diagnosis of Cushing''''s syndrome[J]. Chinese Journal of Practical Internal Medicine, 2006, 26(22): 1784-1787
Authors:Lu Lin  Zeng Zhengpei  Tao Hong  et al.
Affiliation:Lu Lin,Zeng Zhengpei,Tao Hong,et al.Chinese Academy of Medical Sciences,Peking Union Medical College Hospital,Beijng 100730,China
Abstract:
Objective To evaluate effects of the combined and classic dexamethasone suppression test(DST)on the diagnosis of Cushing's syndrome.Methods Retrospective analysis was made about the results of DST from 152 patients of Cushing syndrome with surgically confirmed causes in recent 10 years.Results The diagnosis accuracy of overnight low dose DST,classic low dose DST and of combined low dose DST was 97.5%,96.1%and 97.6% respectively for determining diagnosis of Cushing's syndrome.No obvious difference was found in three groups(P=0.86).The diagnosis accuracy of 31 cases of classic and 17 cases of combined high dose DST was 80.6%(25/31)and 76.4% respectively without obvious difference(P =0.73)for locating diagnosis of Cushing's disease.The diagnosis accuracy of classic and combined high dose DST was 94.2% and 95.5% respectively without obvious difference(P =0.83)for locating diagnosis of ACTH independent Cushing's syndrome.Sensitivity and specificity for Cushing's disease were 81.5% and 92.5% in classic low dose and high dose DST and 77.8% and 95.5% in combined low dose and high dose DST.Conclusion Compared to the classic DST,combined DST has the advantages of double controls,simplicity and saving time.Because diagnosis accuracy of combined DST is in accordance with the classic DST,it is recommended to be a routine for diagnosing Cushing's syndrome.
Keywords:Cushing's syndrome  Dexamethasone suppression test
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