4 049例肾上腺病变患者回顾性临床分析  

Clinical analysis of 4 049 hospitalized cases of adrenal lesions

作　　者：李乐乐[1] 窦京涛[1] 谷伟军[1] 杨国庆[1] 杜锦[1] 杨丽娟[1] 臧丽[1] 王先令[1] 金楠[1] 欧阳金芝[1] 吕朝晖[1] 巴建明[1] 母义明[1] 陆菊明[1] 李江源[1] 潘长玉[1] 

机构地区：[1]解放军总医院内分泌科,北京100853

出　　处：《中华医学杂志》2014年第42期3314-3318,共5页National Medical Journal of China

摘　　要：目的 总结肾上腺病变患者的病种构成特点,分析疾病谱变迁,以进一步指导临床工作.方法 收集1993年8月1日至2013年7月31日在解放军总医院住院影像学检查提示肾上腺有异常改变的病例资料,包括性别、年龄、入院日期、临床诊断、就诊科室、是否手术、术后病理诊断、影像学资料等,对其进行回顾性分析.结果 （1）20年间就诊于我院的肾上腺病变患者共4049例,其中男2004例（49.49％）,女2045例（50.51％）,平均就诊年龄为（46.82±13.36）岁.（2）我院肾上腺病变及肾上腺意外瘤住院病例数均呈逐年上升趋势,就诊年龄多住30～60岁,且肾上腺意外瘤在总体肾上腺疾病中所占比例也呈逐年增加趋势,随年龄递增呈上升趋势.（3）内分泌功能评估结果：无功能性病变所占比例最高,占49.88％;功能性病变中,居于首位的是原发性醛固酮增多症,占22.04％,其次为库欣综合征,占8.60％,嗜铬细胞瘤所占比例占7.80％.（4）近20年,无功能性病变在总体中所占比例由20.97％上升至54.11％（P＜0.05）;功能性病变中,各时间段原发性醛固酮增多症所占比例均为最高,但呈逐渐下降趋势,由29.84％下降至20.43％ （P＜0.05）;嗜铬细胞瘤所占比例也呈下降趋势,由18.55％下降至6.99％（P＜0.05）;肾上腺性库欣综合征比例变化不大.结论 近20年来我院收治的肾上腺病变病例数呈逐年上升趋势.肾上腺意外瘤所占比重显著增加;肾上腺病变疾病谱有所改变,肾上腺无功能性病变所占比重上升,功能性病变所占比重下降.Objective To summarize the disease distribution characteristics of adrenal lesions and analyze the changes of disease spectrum so as to further guide clinical practices.Methods All clinical data of adrenal lesion patients hospitalized between 1993 and 2013 were collected.Their profiles of gender ratio,visiting age,final diagnosis and year of hospitalization were retrospectively analyzed.Results A total of 4 049 patients with adrenal lesions were admitted.There were 2 004 males and 2 045 females with a mean age of 46.82 ± 13.36 years.The number of cases gradually increased year-on-year.And the visiting age was 30-60 years.The annual proportion of adrenal incidentaloma out of total adrenal lesions gradually increased with advancing age.Among them,3 014 received endocrine function assessments.And there were nonfunctional lesions （n =1 503,49.88%）,adrenal Cushing＇ s syndrome （n =259,8.60%）,primary aldosteronism （n =665,22.04%） and pheochromocytoma （n =235,7.80%）.The proportion of nonfunctional lesions rose from 20.97% to 54.11% （P 〈 0.05）.The proportion of primary aldsteronism declined from 29.84% to 20.43% （P 〈 0.05）.And the proportion of adrenal Cushing syndrome changed slightly （P 〉 0.05）.The proportion of pheochromocytoma declined from 18.55% to 6.99% （P 〈 0.05） Conclusion The number of patients gradually increased over the last two decades.So did the proportion of adrenal incidentaloma.The disease spectrum of adrenal lesions has changed.And the proportion of nonfunctional lesions increased while that of functional lesions declined.Wang Xianling,

关 键 词：肾上腺疾病 肾上腺意外瘤 库欣综合征 原发性醛固酮增多症 嗜铬细胞瘤 

分 类 号：R736.6[医药卫生—肿瘤]