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垂体依赖性肾上腺皮质功能亢进犬的垂体肿瘤大小、神经体征及其与内分泌检查结果的关系:43例(1980 - 1990年)

Pituitary tumor size, neurologic signs, and relation to endocrine test results in dogs with pituitary-dependent hyperadrenocorticism: 43 cases (1980-1990).

作者信息

Kipperman B S, Feldman E C, Dybdal N O, Nelson R W

机构信息

Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California, Davis 95616.

出版信息

J Am Vet Med Assoc. 1992 Sep 1;201(5):762-7.

PMID:1328121
Abstract

Pituitary neoplasm was identified in 43 dogs with pituitary-dependent hyperadrenocorticism via necropsy (n = 33), diagnostic imaging with computerized tomography or magnetic resonance imaging (n = 5), or diagnostic imaging and necropsy (n = 5). All dogs had clinical signs and clinicopathologic test results typical of hyperadrenocorticism. Thirty-seven dogs had grossly visible pituitary tumors, and 6 dogs had microscopic pituitary tumors. Fifteen dogs had developed neurologic signs typical of those resulting from an enlarging pituitary mass. Twenty-three dogs had pituitary tumors greater than or equal to 1 cm in diameter. Provocative testing of the pituitary-adrenocortical axis was performed on all dogs. Dogs with grossly visible pituitary tumors and dogs with neurologic signs had significantly (P less than 0.05) higher mean plasma endogenous ACTH concentrations, compared with values from dogs with microscopic tumors and dogs without neurologic signs, respectively. Dogs with grossly visible pituitary tumors and dogs with tumors greater than or equal to 1 cm in diameter had significantly (P less than 0.05) lower adrenocortical responsiveness to exogenous ACTH, compared with dogs with microscopic pituitary tumors and dogs with tumors less than 1 cm in diameter, respectively. Despite these differences, there was overlap between test results among dogs. On the basis of endocrine test results, it would appear difficult to distinguish dogs with pituitary-dependent hyperadrenocorticism and large pituitary tumors from those with pituitary-dependent hyperadrenocorticism and microscopic pituitary tumors prior to onset of neurologic signs.

摘要

通过尸检(n = 33)、计算机断层扫描或磁共振成像诊断性成像(n = 5)或诊断性成像与尸检(n = 5),在43只患有垂体依赖性肾上腺皮质功能亢进的犬中发现了垂体肿瘤。所有犬均有肾上腺皮质功能亢进的典型临床症状和临床病理检查结果。37只犬有肉眼可见的垂体肿瘤,6只犬有显微镜下可见的垂体肿瘤。15只犬出现了垂体肿块增大所致的典型神经症状。23只犬的垂体肿瘤直径大于或等于1 cm。对所有犬进行了垂体-肾上腺皮质轴的激发试验。与显微镜下肿瘤犬和无神经症状犬相比,有肉眼可见垂体肿瘤的犬和有神经症状的犬的平均血浆内源性促肾上腺皮质激素(ACTH)浓度显著更高(P < 0.05)。与显微镜下垂体肿瘤犬和直径小于1 cm的肿瘤犬相比,有肉眼可见垂体肿瘤的犬和直径大于或等于1 cm的肿瘤犬对外源性ACTH的肾上腺皮质反应性显著更低(P < 0.05)。尽管存在这些差异,但犬之间的检测结果仍有重叠。基于内分泌检测结果,在神经症状出现之前,似乎很难区分患有垂体依赖性肾上腺皮质功能亢进和大垂体肿瘤的犬与患有垂体依赖性肾上腺皮质功能亢进和显微镜下垂体肿瘤的犬。

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