血细胞、电解质等对库欣病的诊断和治疗价值探讨  

Correlation between blood cells,electrolyte changes and diagnosis and treatment of Cushing's disease

作　　者：施秀华[1] 范长燕[2] 孙青芳[2] 卞留贯[2] 李云峰[2] 郑励力[2] 赵卫国[2] 沈建康[2] 宁光[3] 周勤[1] 韦永明[1] 

机构地区：[1]安徽省芜湖市第二人民医院肿瘤科,安徽芜湖241000 [2]上海交通大学附属瑞金医院神经外科,上海200025 [3]上海交通大学附属瑞金医院内分泌科,上海200025

出　　处：《中华神经外科疾病研究杂志》2012年第4期331-335,共5页Chinese Journal of Neurosurgical Disease Research

基　　金：上海自然科学基金资助项目(Z08ZR1413)

摘　　要：目的评价库欣病患者经鼻蝶垂体腺瘤切除术(TSS)术前术后的血细胞、血电解质及血糖血压水平与其手术缓解效果的相关性,探讨血细胞、血电解质等常规检查对库欣病患者的治疗价值,评估这些实验室一般检查对库欣病手术疗效及诊断的指导意义。方法以2003年1月至2009年12月经病理证实为垂体促肾上腺皮质激素(ACTH)腺瘤的101例库欣病患者为研究对象,均行经鼻蝶窦垂体腺瘤切除术。按库欣病缓解标准分为手术缓解组(A组)和未缓解组(B组),收集所有患者术前、术后及术后跟踪随访(术后1个月、3个月、6个月及1年之后)的血细胞(白细胞、中性粒细胞、嗜酸性粒细胞、淋巴细胞和红细胞)、电解质(钠离子、钾离子和钙离子)水平及术前术后的血压、空腹血糖的水平。结果 A组与B组的术前术后1个月、3个月、6个月及1年随访中在血细胞、电解质方面具有显著性差异。术前术后的血压及空腹血糖也有显著性的变化。结论 TSS治疗可改善库欣病患者术前血细胞、电解质的异常水平;缓解组与未缓解组的血细胞和电解质水平有显著差异,术前术后短期内的血压、空腹血糖也有显著变化。相比耗费大、条件苛刻的内分泌学检查项目,库欣病患者的血细胞、电解质水平的动态变化以及术后血压及血糖的改变也可作为评估垂体瘤手术疗效的重要指标,这在临床上有着不可小视的作用。Objective To evaluate the correlation between pre-operative and post-operative blood cells,electrolytes,blood sugar level,blood pressure of patients with Cushing＇s disease and transsphenoidal resection outcome of pituitary adenoma（TSS） and to discuss their effects on the diagnosis and treatment of Cushing＇s disease.Methods A total of 101 cases of Cushing＇s disease admitted from January 2003 to December 2009 underwent transsphenoidal surgery.According to Cushing＇s disease remission criteria,all the patients were divided into remission group（group A） and unremission group（group B）.The data of blood cells（leukocytes,neutrophils,eosinophils,lymphocytes and red blood cells）,electrolytes（sodium,potassium and calcium） levels and blood pressure before and after operation（systolic blood pressure and diastolic blood pressure）,fasting blood glucose levels in all patients before and after surgery（1 month,3 months,6 months,1 year post-operation） were collected.ResultsThere was significant difference in blood cells and electrolytes level in pre-operation and 1 month,3 months,6 months and 1 year post-operation between group A and group B.There was significant difference in blood pressure and fasting blood glucose levels between pre-operation and post-operation.ConclusionTSS treatment can improve the pre-operative blood cells and electrolyte abnormalities of Cushing＇s disease.The dynamic changes of blood cells and electrolyte levels can also be used to assess the clinical diagnosis and surgical treatment,and the post-operative changes in blood pressure and blood sugar also indicate the efficacy of surgery,all of which is valuable for the comprehensive treatment of Cushing＇s disease.

关 键 词：库欣病 血细胞 电解质 

分 类 号：R651[医药卫生—外科学]