促肾上腺皮质激素非依赖性肾上腺皮质大结节增生症12例临床分析  

Diagnosis and treatment of adrenocorticotropic hormone-independent macronodular adrenocorticai hyperplasia

作　　者：李江[1] 李黎明[1] 

机构地区：[1]天津医科大学总医院泌尿外科,300052

出　　处：《中华全科医师杂志》2012年第4期292-294,共3页Chinese Journal of General Practitioners

摘　　要：回顾分析12例促肾上腺皮质激素（ACTH）非依赖性肾上腺皮质大结节增生症（AIMAH）患者的临床资料．12例均具有库欣综合征的临床和生化特点，大、小剂量地塞米松抑制试验均不被抑制，血浆ACTH水平降低。CT检查均示双侧肾上腺结节样增生，均经病理检查证实为双侧肾上腺大结节样增生，4例行双侧肾上腺全切术后血压正常，随访8年，未升高；8例行单侧肾上腺切除．术后血压明显下降，但3年后血压复升，2例再行对侧肾上腺全切除后治愈，术后均无纳尔逊（Nelson）综合征.Twelve eases of adrenoeortieotropie hormone-independent rnaeronodular adrenoeortieal hyperplasia were retrospectively reviewed. All eases had physical signs and biochemical evidence of Cushing syndrome. Urinary free cortisone （UFC） levels were not suppressed by high dose and low dose dexamethasone suppression tests, and plasma adrenocortieotropie hormone levels were low in all patients. CT scan showed bilateral enlarged adrenal glands in all eases, and histopathologie examination eonfirmed bilateral adrenal nmeronodular hyperplasia. The follow-up revealed that 4 patients had a normal blood pressure 8y after bilateral adrenaleetomy. In 8 eases the hlood pressure was rebound 3y after single side adrenalectomy, 6 of whom had medical treatment; 2 of whom had cnntralateral adrenalectomy and the blood pressure returned to normal afterwards. There was no Nelson syndrome in all cases.

关 键 词：肾上腺皮质疾病 库欣综合征 

分 类 号：R586[医药卫生—内分泌]