中华神经外科杂志
中華神經外科雜誌
중화신경외과잡지
Chinese Journal of Neurosurgery
2015年
11期
1131-1134
,共4页
陈适%卢琳%童安莉%潘慧%朱慧娟%茅江峰%陆召麟
陳適%盧琳%童安莉%潘慧%硃慧娟%茅江峰%陸召麟
진괄%로림%동안리%반혜%주혜연%모강봉%륙소린
库欣综合征%青少年%定性诊断%敏感性与特异性
庫訢綜閤徵%青少年%定性診斷%敏感性與特異性
고흔종합정%청소년%정성진단%민감성여특이성
Cushing's syndrome%Adolescent%Qualitative diagnosis%Sensitivity and specificity
目的 分析青少年库欣综合征(CS)的临床特点和定性诊断方法.方法 对1990年1月至2012年3月北京协和医院内分泌科收治的50例青少年CS患者的临床特点和实验室检查结果进行回顾性分析.结果 患者就诊年龄(14±4)岁,男:女=1.00:1.17.50例CS患者中,36例(72％)患有库欣病,为最常见的病因.CS患者临床表现典型,锁骨上脂肪垫、满月脸、向心性肥胖、水牛背症状出现比例均超过90％;63％的青少年CS患者身高低于第3百分位,42％的患者体质量高于第75百分位.高血压、骨质疏松、糖代谢紊乱、高脂血症也较常见.若采用1.8μg/dl为切点,则午夜血清皮质醇诊断敏感性最高(100％);经典小剂量地塞米松抑制试验、24 h尿游离皮质醇和过夜小剂量地塞米松抑制试验的敏感性分别为95％、88％和70％.结论 青少年CS患者的最常见病因为库欣病,临床表现较典型,包括身材矮胖等.午夜血清皮质醇在切点为1.8 μg/dl时,其诊断敏感性最高.
目的 分析青少年庫訢綜閤徵(CS)的臨床特點和定性診斷方法.方法 對1990年1月至2012年3月北京協和醫院內分泌科收治的50例青少年CS患者的臨床特點和實驗室檢查結果進行迴顧性分析.結果 患者就診年齡(14±4)歲,男:女=1.00:1.17.50例CS患者中,36例(72％)患有庫訢病,為最常見的病因.CS患者臨床錶現典型,鎖骨上脂肪墊、滿月臉、嚮心性肥胖、水牛揹癥狀齣現比例均超過90％;63％的青少年CS患者身高低于第3百分位,42％的患者體質量高于第75百分位.高血壓、骨質疏鬆、糖代謝紊亂、高脂血癥也較常見.若採用1.8μg/dl為切點,則午夜血清皮質醇診斷敏感性最高(100％);經典小劑量地塞米鬆抑製試驗、24 h尿遊離皮質醇和過夜小劑量地塞米鬆抑製試驗的敏感性分彆為95％、88％和70％.結論 青少年CS患者的最常見病因為庫訢病,臨床錶現較典型,包括身材矮胖等.午夜血清皮質醇在切點為1.8 μg/dl時,其診斷敏感性最高.
목적 분석청소년고흔종합정(CS)적림상특점화정성진단방법.방법 대1990년1월지2012년3월북경협화의원내분비과수치적50례청소년CS환자적림상특점화실험실검사결과진행회고성분석.결과 환자취진년령(14±4)세,남:녀=1.00:1.17.50례CS환자중,36례(72％)환유고흔병,위최상견적병인.CS환자림상표현전형,쇄골상지방점、만월검、향심성비반、수우배증상출현비례균초과90％;63％적청소년CS환자신고저우제3백분위,42％적환자체질량고우제75백분위.고혈압、골질소송、당대사문란、고지혈증야교상견.약채용1.8μg/dl위절점,칙오야혈청피질순진단민감성최고(100％);경전소제량지새미송억제시험、24 h뇨유리피질순화과야소제량지새미송억제시험적민감성분별위95％、88％화70％.결론 청소년CS환자적최상견병인위고흔병,림상표현교전형,포괄신재왜반등.오야혈청피질순재절점위1.8 μg/dl시,기진단민감성최고.
Objective To analyze the clinical features and qualitative diagnosis methods of Cushing's syndrome (CS) in adolescence.Methods The clinical features and laboratory findings of 50 adolescent patients with CS admitted to the Department of Endocrinology, Peking Union Medical College Hospital from January 1990 to March 2012 were analyzed retrospectively.Results The age of medical treatment was 14--4 years.Male : female =1.00 : 1.17.Thirty-six adolescent patients (72％) had CS, and it was the most common cause.The proportions of the typical clinical manifestations, supraclavicular fat pads, moon face, centripetal obesity, and buffalo hump of the adolescent patients were more than 90％.The height of 63％ adolescent patients with CS was below the third percentile, but the body mass of 42％ adolescent patients was higher than the 75th percentile.Hypertension, osteoporosis, glucose metabolism disorder, and hyperlipidemia were also more common.If the 1.8 μg/dl cut-off point was used, the diagnostic sensitivity of midnight serum cortisol was the highest (100％);followed by the classic low-dose dexamethasone suppression test, 24 h urine free cortisol and overnight low-dose dexamethasone suppression test, their sensitivities were 95％, 88％, and 70％, respectively.Conclusions The most common cause is CS in adolescent patients with CS.The clinical manifestations are more typical, including dumpy figure, etc.When the midnight serum cortisol cut-off point is 18.8 μg/dl, its diagnostic sensitivity is the highest.
