CAJ | 학술논문

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4 049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.
목적 총결신상선병변환자적병충구성특점,분석질병보변천,이진일보지도림상공작.방법 수집1993년8월1일지2013년7월31일재해방군총의원주원영상학검사제시신상선유이상개변적병례자료,포괄성별、년령、입원일기、림상진단、취진과실、시부수술、술후병리진단、영상학자료등,대기진행회고성분석.결과 (1) 20년간취진우아원적신상선병변환자공4 049례,기중남2004례(49.49％),녀2045례(50.51％),평균취진년령위(46.82±13.36)세.(2)아원신상선병변급신상선의외류주원병례수균정축년상승추세,취진년령다주30～ 60세,차신상선의외류재총체신상선질병중소점비례야정축년증가추세,수년령체증정상승추세.(3)내분비공능평고결과:무공능성병변소점비례최고,점49.88％;공능성병변중,거우수위적시원발성철고동증다증,점22.04％,기차위고흔종합정,점8.60％,기락세포류소점비례점7.80％.(4)근20년,무공능성병변재총체중소점비례유20.97％상승지54.11％ (P＜0.05);공능성병변중,각시간단원발성철고동증다증소점비례균위최고,단정축점하강추세,유29.84％하강지20.43％ (P ＜0.05);기락세포류소점비례야정하강추세,유18.55％하강지6.99％(P＜0.05);신상선성고흔종합정비례변화불대.결론 근20년래아원수치적신상선병변병례수정축년상승추세.신상선의외류소점비중현저증가;신상선병변질병보유소개변,신상선무공능성병변소점비중상승,공능성병변소점비중하강.
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.