库欣综合征低钾血症发生与氢化可的松关系的探讨

①目的　探讨库欣综合征病人低钾血症的发生与氢化可的松的关系。②方法　采用放免法测定 6 4例库欣综合征病人 2 4h尿游离氢化可的松 (UFC) ,血清氢化可的松 (SC)及血浆促皮质素 (ACTH)水平 ,比较增生型与腺瘤型病人中低钾血症组与非低钾血症组之间UFC ,SC和ACTH等指标的差异。③结果　库欣综合征中增生型及腺瘤型病人低钾血症的发生率均较高 ,分别为 30 .4 3%及 33.33% .增生型中低钾血症者UFC ,SC(2 4 :0 0 ,8:0 0 ) ,血浆ACTH(8:0 0 )含量显著高于无低钾血症者 ,差异有显著性 (t=2 .10～ 3.0 2 ,P <0 .0 5 ) ;腺瘤型中有低钾血症者仅UFC含量显著高于无低钾血症者 (t=3.2 7,P <0 .0 5 )。直线相关分析表明 ,低钾血症的发生与UFC含量呈正相关 (r=0 .32 5 ,P <0 .0 5 )。④结论　库欣综合征病人低钾血症的发生与体内氢化可的松水平有关 ,UFC水平可作为预测低钾血症是否发生的一个重要指标

RELATIONSHIP BETWEEN HYPOKALEMIA AND HYDROCORTISONE IN CUSHING SYNDROME

Objective\ To study the relationship between the occurrence of hypokalemia and hydrocortisone in patients with Cushing syndrome. \ Methods\ The total free urinary cortisol(TUFC) in 24 hours, serum cortisol(SC) and plasma ACTH were detected with radioimmunoassay method in 64 patients with Cushing syndrome. The differences of TUFC, SC and ACTH were compared between the cases with hyperplasia and adenoma.\ Results\ The incidence of hypokalemia was 30.43% and 33.33% for cases with hyperplasia and adenoma, respectively. The TUFC, SC(24:00,8:00), and ACTH (8:00) were significantly higher in patients with hypokalemia than those without, showing significant difference( t=2.10-3.02,P <0.05). Only the TUFC was significantly higher in patients with adenoma along with hypokalemia than those without( t=3.27,P <0.05). A liner regression analysis showed a positive correlation between hypokalemia and TUFC( r=0.325,P <0.05).\ Conclusion\ The occurrence of hypokalemia in patients with Cushing syndrome is related to the level of cortisol. The TUFC may be used as an important parameter to predict the development of hypokalemia.