原发性醛固酮增多症合并亚临床库欣综合征的研究进展  

Research progress of primary hyperaldosteronism with subclinical Cushing′s syndrome

作　　者：龚欣怡 蔡芸莹[1] 苏恒[1] Gong Xinyi;Cai Yunying;Su Heng(Department of Endocrinology,the First People′s Hospital of Yunnan Province,the Affiliated Hospital of Kunming University of Science and Technology,Kunming 650032,China)

机构地区：[1]云南省第一人民医院内分泌科,昆明理工大学附属医院,昆明650032

出　　处：《国际内分泌代谢杂志》2024年第5期338-341,共4页International Journal of Endocrinology and Metabolism

基　　金：云南省高层次人才培养项目(L-201624);云南省万人计划名医专项(YNWR-MY-2019-020)。

摘　　要：原发性醛固酮增多症(primary aldosteronism,PA)合并亚临床库欣综合征(subclinical Cushing′s syndrome,SCS),被认为是PA的一种亚型,占所有PA患者的10%~20%。该类患者与不良代谢的危险因素相关,如可导致心血管并发症、糖代谢受损、肾脏损害、骨质疏松症的风险增加等,甚至引起焦虑及抑郁,应积极启动对所有PA患者1 mg地塞米松过夜抑制试验的筛查。PA合并SCS的患者可有不同分泌形式,肾上腺静脉采血的结果需谨慎解读,并进一步进行个体化的治疗,术后对肾上腺皮质功能进行评估以决定是否选择糖皮质激素替代治疗。Primary aldosteronism(PA)plus subclinical Cushing′s syndrome(SCS),is considered to be a subtype of PA,the incidences of which have ranged between 10%and 20%.Recent studies reported that these patients were associated with risk factors of adverse metabolism,which can lead to cardiovascular complications,impaired glucose metabolism,kidney damage,and increased risk of osteoporosis,etc,even cause anxiety and depression.The patients with PA should have a low-dose overnight dexamethasone suppression test to screen for hypercortisolism.The patients with PA and SCS have different secretory forms,the final decision for lateralization by adrenal venous sampling(AVS)needs more carefully.According to the results of AVS to select individualized treatment.Postoperative adrenal function evaluation could be used to determine the need for glucocorticoid replacement therapy.

关 键 词：原发性醛固酮增多症 亚临床库欣综合征 轻度自主皮质醇分泌 

分 类 号：R586.24[医药卫生—内分泌] R586.2[医药卫生—内科学]