22例皮质醇增多症的临床研究

目的：探讨皮质醇增多症的临床表现和内分泌检查等辅助检查的意义.方法：从年龄、性别、病程及实验室检查等方面,观察22例不同原因所致皮质醇增多症患者不同的临床表现和测定实验室检查指标.结果：22例中诊断库欣病（增生型）14例63.6％,其中13例（92.9％）得到MRI检查证实],肾上腺腺瘤6例27.3％,均得到MRI检查证实（100％）],另有肾上腺结节样增生1例（4.5％）,异位ACTH综合征1例（4.5％）.临床表现：按出现的频率前4位依次为,库欣病：高血压（100％）、满月脸（92.9％）、向心性肥胖（85.7％）、多血质（85.7％）,肾上腺腺瘤：高血压（100％）、满月脸（100％）、向心性肥胖（100％）、多血质（83.3％）.实验室检查：小剂量地塞米松不能抑制：库欣病与肾上腺腺瘤均为100％.结论：根据高血压、满月脸、向心性肥胖,小剂量地塞米松抑制试验和MRI检查可诊断绝大多数皮质醇增多症.

Clinical study of 22 cases with hypercortisolism

Objective：To explore the significance of clinical manifestations,auxiliary examinations including endocrine examination in patients with hypercortisolism.Methods：Different clinical manifestations and results of laboratory indexes were observed and examined in 22 cases with hypercortisolism.Results：In 22 patients with hypercortisolism,there were 14 patients （63.6%） with Cushing disease in which,13 patients （92.9%） were confirmed by MRI],and six patients （27.3%） with adrenal adenoma They were all confirmed by MRI （100%）],one patient （4.5%） with adrenal nodular hyperplasia,and one patient （4.5%） with dystopia ACTH syndrome.Clinical manifestation：The front four were hypertension （100%）,moon face （92.9%）,central obesity （85.7%）,plethora （85.7%） in patients with Cushing disease,and hypertension （100%）,moon face （100%）,central obesity （100%）,plethora （83.3%） in patients with adrenal adenoma.Laboratory examination：patients unable inhibited by small dose dexamethasone were 100% in patients with Cushing disease and adrenal adenoma.Conclusion：The most patients with hypercortisolism may be diagnosed according to hypertension,moon face,central obesity,inhibition test by small dose dexamethasone and MRI examine.