要重视肾上腺结核的识别和治疗  

Identification and treatment of adrenal tuberculosis

作　　者：陈莉萍 齐宝玉 柏宏伟 CHEN Liping;QI Baoyu;BAI Hongwei(Department of Urology,The Eighth Medical Center of PLA General Hospital,Beijing 100091,China)

机构地区：[1]中国人民解放军总医院第八医学中心泌尿外科,北京100091

出　　处：《现代泌尿外科杂志》2022年第6期449-452,共4页Journal of Modern Urology

摘　　要：肾上腺结核可来自结核菌的原发感染或血行、淋巴播散,临床少见但误诊率较高。早期或单侧病变的症状隐匿,当双侧肾上腺破坏90%以上时,可出现肾上腺皮质功能不全甚至肾上腺危相,是艾迪森氏病的第二大病因。肾上腺CT是最有价值的影像学检查手段,肾上腺皮质功能测定、结核菌病原学检查及病理学检查亦具有重要诊断价值。在抗结核药物治疗基础上联合激素替代治疗、外科干预为主的综合治疗手段对于病灶清除、提高治愈率、预防并发症至关重要。Adrenal tuberculosis is rare but easily misdiagnosed,which may be caused by tubercle bacilli primary infection,and hematogenous/lymphatic diffusion.The symptoms of early or unilateral lesions are hidden.When more than 90%of bilate-ral adrenal glands are destroyed,adrenal cortex dysfunction or adrenal risk may occur,which is the second largest cause of Addison s disease.Adrenal gland CT is the most valuable imaging examination.Adrenocortical function determination and patholo-gical examination also exhibit diagnostic value.A combined treatment including antitubercular therapy,hormone replacement and surgical intervention is vital for debriding focus,improving recovery,and preventing complications.

关 键 词：肾上腺结核 肾上腺 结核 肾上腺功能不全 艾迪森氏病 结核杆菌 诊断 治疗 

分 类 号：R586[医药卫生—内分泌]