双侧岩下窦采血在疑难库欣病的诊断及手术疗效评估中的应用(附10例病例)  

Evaluation of Diagnosis and Surgical Effect of Bilateral Inferior Petrosal Sinus Sampling in Difficult Cushing's Disease(Report of 10 Cases)

作　　者：郑思阳[1] 尹卫[1] 黄达[1] 齐辉[1] ZHENG Si-yang;YIN Wei;HUANG Da;QI Hui(Department of Neurosurgery,Peking University Shenzhen Hospital,Shenzhen 518036,Guangdong Province,China)

机构地区：[1]广东省深圳市北京大学深圳医院神经外科,广东深圳518036

出　　处：《罕少疾病杂志》2022年第11期88-90,共3页Journal of Rare and Uncommon Diseases

摘　　要：目的探讨双侧岩下窦采血在疑难库欣病确诊及评估手术疗效中的价值。方法回顾性分析我院自2017年9月至2020年6月间诊治并手术治疗的10例疑难库欣病患者,术前行双侧岩下窦采血和外周血采样对比血ACTH浓度,明确诊断后手术治疗。术后2~6月再次返院复查岩下窦静脉血采样分析,评价手术疗效。结果10例疑难综合征患者的术前双侧岩下窦静脉血和外周血采样ACTH浓度比值均超过2:1,手术病理结果均为ACTH腺瘤,确诊率100%。术后患者症状好转复查双侧岩下窦采血,ACTH浓度恢复正常。结论双侧岩下窦采血安全可靠,既可作为疑难病例的确诊手段,也可作为疑难库欣病手术疗效的评价标准。Objective To explore the value of bilateral inferior petrosal sinus sampling in the diagnosis and evaluation of surgical efficacy of difficult Cushing's disease.Methods A retrospective analysis of the diagnosis and treatment of 10 cases of difficult Cushing’s disease patients in our hospital from September 2017 to June 2020 was studied,blood samples were collected from bilateral inferior petrosal sinuses and peripheral blood samples were also taken to compare the blood ACTH concentration before operation,surgical treatments were performed after definite diagnosis,the blood samples of inferior petrosal sinus were collected and analyzed again to evaluate the effect of the operation two to six months later.Results The ratio of ACTH concentration in bilateral inferior petrosal sinus venous blood and peripheral blood was more than 2:1,All pathological results were ACTH adenomas,the diagnosis rate was 100%.Bilateral inferior petrosal sinus sampling were taken again after the symptoms improved,ACTH concentration returned to normal.Conclusion Bilateral inferior petrosal sinus sampling is safe and reliable,it can be used not only as a means of diagnosis of difficult cases,but also as an evaluation standard of surgical efficacy of difficult Cushing's disease.

关 键 词：岩下窦采血 疑难库欣病 诊断 手术疗效评估 

分 类 号：R540.4[医药卫生—心血管疾病]