在患有情绪障碍的患者中,谁以及如何选内源性高皮质醇症
Emanuele Ferrante1, Chiara Simeoli2, Giovanna Mantovani1,3
1Endocrinology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
Journal of endocrinological investigation
|November 12, 2024
概括
情绪障碍与库辛综合征 (CS) 有关,这是一种皮质醇过多的情况. 对于情绪障碍患者来说,查至关重要,但由于症状重叠,诊断可能具有挑战性.
科学领域:
- 内分泌学 在内分泌学.
- 精神病学是一个精神病学.
- 内部医学 内部医学
背景情况:
- 情绪障碍和内源性皮质过高,特别是库辛综合征 (CS) 之间存在着强烈的联系.
- 重度抑郁症是CS患者中最常见的情绪障碍 (50-80%),有时是第一个临床症状.
- 情绪障碍患者中高皮质醇症的患病率和最佳查策略仍然不清楚.
研究的目的:
- 为了突出情绪障碍与库辛综合征之间的关联.
- 讨论情绪障碍患者中CS查方面的挑战.
- 强调需要准确的诊断方法和专门的中心.
主要方法:
- 对临床和史学特征的审查,以指导CS查.
- 讨论高皮质醇症的诊断测试,包括尿皮质醇,唾液皮质醇和德克萨米他抑制测试.
- 考虑CS和非新发性高皮质醇症 (NNH) 之间的差异诊断以及动态测试的作用.
主要成果:
- 临床评估,包括特定的CS症状,并发症和治疗耐药性,有助于识别患者进行CS查.
- 对于高皮质醇症的初始查测试在准确性上有局限性.
- 从NNH区分CS是复杂的,通常需要纵向跟踪和先进的动态测试.
结论:
- 对于情绪障碍患者来说,全面的评估和随访至关重要,以检测潜在的CS.
- 诊断陷和症状与NNH等疾病重叠,需要专家评估.
- 建议转诊到专门的中心,以进行准确的CS诊断和管理.
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