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原发性双边巨性上腺增生,呈现为具有双边上腺质量的抗性高血压:一个病例报告

Yu-Yun Su¹, Ti-Yuan Yang², Cheng-Yu Lin³

¹Division of Endocrinology and Metabolism (Taipei), Department of Internal Medicine, MacKay Memorial Hospital, Taipei, Taiwan.

Annals of medicine and surgery (2012)

|February 12, 2026

概括

主要双边巨性上腺增生 (PBMAH) 可以导致库辛综合征. 单边上腺切除术有效地治疗了患有PBMAH的患者,改善了高血压和血糖控制,而不会导致上腺功能不充分.

科学领域:

内分泌学在内分泌学.
手术瘤学手术瘤学
上腺腺疾病上腺疾病

背景情况:

双边上腺瘤不常见,可能表明自主皮质醇分泌.
主要双边巨性上腺增生症 (PBMAH) 是一种罕见的 adrenocorticotropic 激素 (ACTH) 独立的库辛综合征的原因.
PBMAH可能没有经典的Cushingoid特征,从而使诊断复杂化.

研究的目的:

为了呈现一个ACTH独立的库辛综合征的病例,由于双边上腺增生.
突出单边上腺切除术作为PBMAH治疗的有效性.
强调上腺静脉采样在手术决策中的作用.

主要方法:

一名患有抗性高血压和肌肉衰弱的59岁男子接受了生物化学评估和计算机断层扫描.
进行了上腺静脉取样 (AVS),以确定主要的皮质醇产量.
进行了腹腔镜左上腺切除术,随后进行了组织病理学分析.

主要成果:

生物化学测试证实了自主皮质醇分泌和双边上腺质量.
AVS显示左侧主导皮质醇的产生.
上腺切除术后,患者的高血压和血糖控制显著改善.

结论:

单边上腺切除术是PBMAH的可行的功能治疗方法.
在双边上腺增生与皮质醇过剩的情况下,AVS对于指导外科手术至关重要.
这种方法可以控制皮质醇过量,同时最大限度地降低永久性上腺功能衰竭的风险.

关键词:

独立于上皮质激素的库辛综合征.双边上腺偶发性瘤主要的双边巨腺上腺增生症.单边的上腺切除术

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