单边上腺切除术对初级双边上腺巨血症的长期结果
Huixin Zhou1,2, Yaqi Yin2, Peng Zhang3
1School of Medicine, Nankai University, Tianjin, China.
Endocrine
|October 9, 2024
概括
单侧上腺切除术 (U-Adx) 对于一次性双侧巨性上腺增生症 (PBMAH) 显示32%的长期缓解率. 高基线24小时无尿性皮质醇和未抑制的LDDST预测持续的高皮质醇症,影响高血压和骨质疏松症.
科学领域:
- 内分泌学 在内分泌学.
- 手术瘤学手术瘤学
- 上腺疾病 上腺疾病
背景情况:
- 主要双边巨性上腺增生 (PBMAH) 是导致库辛综合征的原因,皮质醇分泌量有所变化.
- 单侧上腺切除术 (U-Adx) 是双侧上腺切除术的首选治疗方法,因为上腺功能缺陷的风险较低.
- 在PBMAH中U-Adx的长期结果和预测因素需要进一步调查.
研究的目的:
- 为了评估单边上腺切除术 (U-Adx) 对初级双边上腺增生症 (PBMAH) 的长期有效性.
- 在PBMAH患者中确定U-Adx后持续性高皮质醇症的预测因素.
- 评估U-Adx对与PBMAH相关的并发症的影响.
主要方法:
- 对61名接受U-Adx.治疗的PBMAH患者的回顾性分析.
- 对手术前后生化标志物 (ACTH,皮质醇,24小时UFC) 和临床结果的评估.
- 预测因素的评估,包括基线荷尔蒙水平和低剂量德甲抑制试验 (LDDST) 结果.
主要成果:
- 在U-Adx后6个月内,48.89%的患者实现了初始缓解.
- 长期缓解率在38.58个月的中位数随访后为32.00%,68.00%的人经历了持续的高皮质醇症.
- 基线24小时UFC>2ULN和未抑制的24小时UFC后LDDST预测了持续的高皮质醇症.
结论:
- U-Adx为PBMAH提供了32%的长期缓解率,并确定了非缓解的显著预测因素.
- 高血压随缓解而改善,而骨质疏松症则随着持续的高皮质醇化而恶化.
- 在PBMAH患者中,U-Adx可以改善荷尔蒙平衡并减轻相关的并发症.
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