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Updated: Jun 18, 2025
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A Novel Method: Super-selective Adrenal Venous Sampling
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协同热激发测试比术后的1日基底皮质醇更有选择性,用于诊断单边上腺切除术后的二次上腺功能不充分
Sean Johnson1, Catherine D Zhang2, Patrick T Hangge3
1Department of Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Annals of surgical oncology
|July 28, 2024
概括
术后第一天的辅助热激素刺激测试 (CST) 有效地识别了患有上腺切除术后二次上腺功能缺陷 (SAI) 风险的患者. 这项测试对于确定是否需要使用葡萄糖皮质醇替代疗法至关重要.
科学领域:
- 内分泌学 在内分泌学.
- 手术瘤学手术瘤学
背景情况:
- 二次上腺功能缺陷 (SAI) 可能发生在单边上腺切除术后的高皮质醇症 (HC) 或初级上腺症 (PA).
- 准确预测SAI风险和需要葡萄糖皮质激素替代剂 (GR) 对于患者管理至关重要.
研究的目的:
- 为了评估手术后的第一天 (POD1) 基底皮质醇水平是否预测异常的Cosyntropin刺激测试 (CST) 结果.
- 确定POD1 CST在确定单边上腺切除术后需要GR的患者中的实用性.
主要方法:
- 对接受单边上腺切除术的患者进行回顾性审查,以治疗HC,PA或两者.
- POD1 CST的表现和基底皮质醇水平的评估.
- 接收器操作特征 (ROC) 曲线分析以确定最佳的皮质醇值,以预测异常的CST结果.
主要成果:
- 在152名测试患者中,有80人 (53%) 患有SAI.
- POD1基底皮质醇水平≤10μg/dL显示出高灵敏度和特异性,用于预测HC患者异常的CST.
- 较低的值 (≤5μg/dL) 对PA/HC患者来说是最佳的,达到100%的灵敏度和特异性.
结论:
- POD1 CST优于单独的基底皮质醇水平,在识别患有SAI后上腺切除术风险的患者方面.
- 该研究建议POD1 CST指导在HC,PA或混合条件的单边上腺切除术后患者的GR决策.
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