CAJ | 학술논문

目的：探讨研究小剂量地塞米松抑制试验对库欣综合征的诊断方法。方法整群选取2012年1月-2015年1月间在该院诊治经临床诊断证实的库欣综合征老年患者34例作为研究对象，选择同期行健康体检的30例健康体检患者作为对照组，记录患者基础8点血清皮质醇水平及2 mgDST后血清皮质醇绝对值，计算其抑制率。分别以血清皮质醇绝对值和抑制率作为2 mgDST对库欣综合征诊断切点，分析两方法与患者术后病理学诊断的符合率，评价诊断准确性。结果血清皮质醇以及24 h尿游离皮质醇数值结果显示，所有患者均表现为8点和24点的血清皮质醇水平升高，且昼夜节律消失。2 mgDST结果观察组2 mgDST后8点血清皮质醇的水平明显下降，与基础8点比较差异有统计学意义(P<0.01)。2 mgDST诊断的准确性结果显示。分别以2 mgDST后8点血清皮质醇水平>5 Lg/dL和抑制率<50%作为切点来诊断库欣综合征，与病理学诊断的符合率分别为97.2%和76.4%，差异有统计学意义(P<0.05)。结论与2 mgDST后抑制率<50%相比，以血清皮质醇>5 Lg/dL为切点诊断库欣综合征的方法准确性更高，因此针对老年库欣综合征患者，采用小剂量地塞米松抑制试验具有更高的诊断应用价值。
목적：탐토연구소제량지새미송억제시험대고흔종합정적진단방법。방법정군선취2012년1월-2015년1월간재해원진치경림상진단증실적고흔종합정노년환자34례작위연구대상，선택동기행건강체검적30례건강체검환자작위대조조，기록환자기출8점혈청피질순수평급2 mgDST후혈청피질순절대치，계산기억제솔。분별이혈청피질순절대치화억제솔작위2 mgDST대고흔종합정진단절점，분석량방법여환자술후병이학진단적부합솔，평개진단준학성。결과혈청피질순이급24 h뇨유리피질순수치결과현시，소유환자균표현위8점화24점적혈청피질순수평승고，차주야절률소실。2 mgDST결과관찰조2 mgDST후8점혈청피질순적수평명현하강，여기출8점비교차이유통계학의의(P<0.01)。2 mgDST진단적준학성결과현시。분별이2 mgDST후8점혈청피질순수평>5 Lg/dL화억제솔<50%작위절점래진단고흔종합정，여병이학진단적부합솔분별위97.2%화76.4%，차이유통계학의의(P<0.05)。결론여2 mgDST후억제솔<50%상비，이혈청피질순>5 Lg/dL위절점진단고흔종합정적방법준학성경고，인차침대노년고흔종합정환자，채용소제량지새미송억제시험구유경고적진단응용개치。
Objective To investigate the study of low-dose dexamethasone test diagnosis of Cushing's syndrome is suppressed. Methods Selected from January 2012 to January 2015 in the hospital,34 cases of elderly patients as research subjects, concomitant healthy selection of 30 healthy patients as a control group, 8:00 records the patient's basic serum cortisol levels and serum cortisol after 2 mgDST absolute value calculate the inhibition rate. Respectively, and the absolute value of serum cortisol suppression rate as 2 mgDST diagnosis of Cushing's syndrome cut-off point, Serum cortisol and urinary free cortisol 24 h numerical results showed that all patients showed serum cortisol levels 8:00 and 24 points increased, and the circadian rhythm disappeared. Results The 2 mgDST after 8:00 serum cortisol levels decreased, with statistical significance (P<0.01) differences between 8:00 and foundation. 2 mgDST diagnostic accuracy of the results displayed. 8:00 respectively, serum cortisol levels after 2mgDST>5Lg/dL and inhibition rate<50%of the cut-off point for the diagnosis of Cushing's syndrome, and the pathological diagnosis coincidence rate was 97.2%and 76.4% (P<0.05). Conclusion Compared to serum cortisol>and 2mgDST inhibitory rate 5Lg/dL as the cutoff point higher di-agnostic accuracy method of Cushing's syndrome, so for elderly patients with Cushing's syndrome, the use of low-dose dexametha-sone suppression diagnostic test has a higher value.