临床前原发性醛固酮增多症和临床前库兴综合征  

Incidental primary aldosteronism and incidental Cushing's syndrome

作　　者：孔垂泽[1] 李泽良[1] 刘同才[1] 张铭铮[1] 杨涛[1] 王玉琳 孙志熙[1] 丁全明 

机构地区：[1]中国医科大学第一临床学院泌尿外科,沈阳110001 [2]盘锦市第一医院 [3]本溪市中心医院

出　　处：《中华泌尿外科杂志》2001年第4期203-205,共3页Chinese Journal of Urology

摘　　要：目的　提高临床前原发性醛固酮增多症和临床前库兴综合征的诊治效果。　方法　回顾性总结 2 0例临床前原发性醛固酮增多症和临床前库兴综合征临床资料。　结果　临床前原发性醛固酮增多症 9例 ,血钾正常低值 5例 ,稍低于正常 3例 ,血醛固酮稍高于正常 4例 ,血浆肾素活性为正常低值 ,3例口服安体舒通治疗有效。临床前库兴综合征 11例 ,早 8时血皮醇增高 3例 ,下午 4时血皮质醇增高 4例 ,血ACTH检查 6例 ,为正常低值或稍低正常 ,3例大剂量地塞米松抑制试验 2例部分被抑制 ,术后临时激素替代疗法 4例。　结论　临床前原发性醛固酮增多症和临床前库兴综合征应根据各项检测结果综合分析作出诊断 ,对自主分泌或存在分泌潜能的肿瘤、≥Objective To study the diagnosis and treatment of some incidental tumors of the adrenal gland. Methods Incidental primary aldosteronism and incidental Cushing's syndrome were reviewed and studied. Results 9 cases of incidental primary aldosteronism have been detected,5 of which demonstrated serum potassium level near the lower limit of normal range and in other 3 lower than normal.In 4 of the cases the plasma aldosterone was higher than normal and the plasma renin level was near the lower limit of normal range.Antisterone test was effective in 3.11 incidental Cushing's syndrome were detected.Serum cortisone was higher in 3 at 8 Am and in 4 at 4 Pm.In 6 cases,ACTH was slightly lower than normal or close to the lower limit of the normal range.High dose dexamethasone suppression test was undertaken in 3 with positive result in 2.Hormone supplement has been required after adrenalectomy in 4. Conclusions Primary aldosteronism and Cushing's syndrome may be incidentally detected on clinical manifestations,laboratoty findings and imaging examination.Adrenalectomy is indicated if there is autonomous hormone secretion or the tumor is larger than 2 cm in diameter or with trend of increasing in size.

关 键 词：醛固酮增多症 肾上腺肿瘤 库兴综合征 

分 类 号：R586.2[医药卫生—内分泌]