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高血压和库辛综合征:寻找红旗的猎物
De Martino M C1, L Canu2, I Bonaventura3
1Dipartimento di Medicina Clinica e Chirurgia, Università degli Studi di Napoli Federico II, Naples, Italy.
Journal of endocrinological investigation
|March 18, 2025
概括
在高血压患者中识别库辛综合征至关重要. 较年轻的患者 (<40岁),患有上腺病变或快速发展的高血压患者应接受这种疾病的查.
科学领域:
- 内分泌学 在内分泌学.
- 高血压研究 高血压研究
- 临床诊断 临床诊断 临床诊断
背景情况:
- 二次高血压会影响5-15%的高血压患者.
- 库辛综合征 (CS) 是一种罕见但严重的高血压原因,增加了心血管风险.
- 识别需要对内源性高皮质醇症进行查的患者是一个临床挑战.
研究的目的:
- 审查高血压患者中库辛综合征的患病率.
- 为了确定最有可能患有库辛综合征的高血压患者的临床表型.
主要方法:
- 按照PRISMA指南进行系统审查.
- 搜索的英语语言研究更新至2023年6月.
- 包括八项研究分析了高血压人群中CS的流行数据和查方法.
主要成果:
- 八项研究 (1977-2020年) 包括11,504名患者.
- 整体CS患病率在0-7.7%之间,库辛病 (CD) 在0-1.2%.
- 在高血压患者<40岁 (6.2%) 和上腺病变患者 (7.7%) 中观察到的最高患病率.
- 一晚1毫克德甲抑制试验 (1毫克DST) 是最常见的选试验.
结论:
- 一个关键的CS概况包括年轻的年龄 (<40岁),快速发展的高血压和上腺腺瘤.
- 患有垂体病变的患者应优先进行诊断工作.
- 对于可疑的CS,建议进行查测试 (UFC,1 mg DST,LNSC);LNSC通常是最具歧视性的.
- 对于患有上腺瘤的高血压患者,建议服用1毫克的DST来排除CS.
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