临床表现,预测因素和尼尔森综合征患者的管理:一项回顾性研究
Pierluigi Mazzeo1,2, Giulia Bovo3,4, Alessandro Mondin3,4
1Department of Medicine-DIMED, University of Padova, Padua, Italy. pierluigi.mazzeo@studenti.unipd.it.
Pituitary
|September 27, 2025
概括
尼尔森综合征 (NS) 影响了30%的双边上腺切除术 (BADX) 后的库辛病患者. 在BADX后更高的ACTH水平和在诊断时更年轻的年龄预测NS,通常需要多式治疗.
科学领域:
- 内分泌学 在内分泌学.
- 在瘤学瘤学.
- 神经外科 神经外科
背景情况:
- 尼尔森综合征 (NS) 或双边上腺切除术 (CTP-BADX/NS) 后的皮质瘤进展,是BADX后库辛病 (CD) 患者的显著并发症.
- 手术切除瘤是主要的治疗方法,但常常需要辅助疗法.
研究的目的:
- 评估BADX后CD患者的临床,放射和荷尔蒙特征.
- 确定CTP-BADX/NS. 的危险因素.
- 评估治疗结果和心脏代谢并发症.
主要方法:
- 对30名接受BADX治疗的CD患者进行了回顾性研究,随访时间至少为18个月.
- 在诊断时和6,24个月后收集的数据,以及最后的随访访问.
- 分析包括临床,放射和荷尔蒙参数.
主要成果:
- 30%的患者 (9/30) 在BADX后平均60个月内发展出NS.
- 在NS患者中,CD诊断较早,BADX后ACTH水平较高.
- 高血压在NS患者中更为普遍;在BADX和更高剂量的皮之前,立体性放射性手术显示出潜在的保护作用.
结论:
- CTP-BADX/NS发生在30%的队列中,较高的BADX后ACTH和CD发病时的年龄较小是潜在的预测因素.
- 没有可靠的荷尔蒙或放射性标志物预测瘤进展.
- 瘤控制通常需要多模式治疗方法,仅仅通过药物治疗的有效性有限.
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