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[1]房春云,常丽纳,何庆,等.原发性肾上腺皮质功能减退症临床分析[J].天津医科大学学报,2021,27(04):401-404.
　FANG Chun-yun,CHANG Li-na,HE Qing,et al.Clinical analysis of primary adrenocortical insufficiency[J].Journal of Tianjin Medical University,2021,27(04):401-404.
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原发性肾上腺皮质功能减退症临床分析(PDF)
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《天津医科大学学报》[ISSN:1006-8147/CN:12-1259/R]

卷:
27卷
期数:
2021年04期
页码:
401-404
栏目:
临床医学
出版日期:
2021-07-20

文章信息/Info

Title:
Clinical analysis of primary adrenocortical insufficiency
文章编号:
1006－8147（2021）04-0401-04
作者:
房春云; 常丽纳; 何庆; 张晓娜; 冯文利; 刘铭
（天津医科大学总医院内分泌代谢科，天津300052）
Author(s):
FANG Chun-yun; CHANG Li-na; HE Qing; ZHANG Xiao-na; FENG Wen-li; LIU Ming
（Department of Endocrinology and Metabolism, General Hospital，Tianjin Medical University，Tianjin 300052，China）
关键词:
原发性肾上腺皮质功能减退症; 临床表现; 实验室检查; 皮质醇; 促肾上腺皮质激素
Keywords:
oncocytoma; chromophobe renal cell carcinoma; magnetic resonance imaging; diffusion weighted imaging; apparent diffusion coefficient; standardized signal intensity
分类号:
R364.5
DOI:
-
文献标志码:
A
摘要:
目的：分析原发性肾上腺皮质功能减退症（PAI）的临床特点。方法：以促肾上腺皮质激素（ACTH，参考范围0～46 pg/mL）水平大于上限2倍为前提，根据清晨血皮质醇（Cor，参考范围为5～25 μg/dL）是否小于5 μg/dL将31例原发性肾上腺皮质功能减退症的患者分为A组（Cor＜5 μg/dL）与B组（5 μg/dL≤Cor＜25 μg/dL，伴有糖皮质激素/盐皮质激素缺乏的症状或体征)，对其临床资料（临床表现及实验室检查）进行回顾性分析并将两组进行对比。结果：A组及B组的临床表现中均以色素沉着、乏力、消化系统症状（纳差、恶心、呕吐）、体重减轻最为常见，A组的上述临床表现的发生率分别为83.33%、75%、75%和50%，B组的上述临床表现的发生率分别为73.68%、63.16%、63.16%和42.11%，两组的临床表现差异均无统计学意义（均P＞0.05）；本研究中主要分析的实验室检查项目为血红蛋白、Na、K、Ca、P和催乳素，两组的上述检查结果均无明显差异（均P＞0.05）。结论：对于临床上可疑PAI的患者要做好筛查工作，不应严格按照清晨血Cor＜5 μg/dL、ACTH＞2倍上限为初步诊断标准。
Abstract:
Objective: To analyze the clinical characteristics of primary adrenocortical insufficiency（PAI）. Methods：On the basis of serum corticotropin （ACTH，reference range 0-46 pg/mL） concentration was 2 times higher than the upper limit of normal range，morning plasma cortisol（Cor，reference range 5-25 μg/dL） less than 5 μg/dL，31 patients with PAI were classified with group A（Cor＜5 μg/dL） and group B（5 μg/dL≤Cor＜25 μg/dL，with symptoms or signs of glucocorticoid/mineralocorticoid deficiency）. The clinical data（clinical manifestations and laboratory tests） were analyzed retrospectively and compared between the two groups. Results：Pigmentation，fatigue，digestive system symptoms（anorexia，nausea，vomiting） and weight loss were the most common clinical manifestations of both group A and group B. The above-mentioned clinical manifestations of group A accounted for 83.33%，75%，75% and 50%，respectively. The above-mentioned clinical manifestations of group B accounted for 73.68%，63.16%，63.16%，and 42.11%，respectively. There was no statistical difference in clinical manifestations between the two groups（all P>0.05）. The main laboratory examination items in this study were Hb，Na，K，Ca，P and prolactin，and there was no significant difference in laboratory examination results between the two groups（all P>0.05）.Conclusion：In clinical practice，when patients are suspected PAI，further detailed screening is needed. Early morning Cor<5 μg/dL and plasma ACTH>2 times upper limit should not be strictly regarded as the preliminary diagnostic criteria.

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备注/Memo

备注/Memo:
基金项目： 国家自然科学基金(81700720，81900720)
作者简介：房春云（1995-），女，硕士在读，研究方向：内分泌与代谢病研究；通信作者：何庆， E-mail：hech69@163.com。
更新日期/Last Update: 2021-07-25