促肾上腺皮质激素（ACTH）和促脂素血浆水平在库欣综合征患者诊断及随访中的比较评估：一项210例病例的研究
Comparative assessment of ACTH and lipotropin plasma levels in the diagnosis and follow-up of patients with Cushing's syndrome: a study of 210 cases.
作者信息
Kuhn J M, Proeschel M F, Seurin D J, Bertagna X Y, Luton J P, Girard F L
机构信息
Laboratoire d'Explorations Fonctionnelles Endocriniennes, hôpital Trousseau, Paris, France.
出版信息
Am J Med. 1989 Jun;86(6 Pt 1):678-84. doi: 10.1016/0002-9343(89)90443-9.
PURPOSE
A series of 210 patients with Cushing's syndrome was evaluated at a single center to assess the relative values of adrenocorticotropic hormone (ACTH) and lipotropin (LPH) plasma levels in the etiologic diagnosis of Cushing's syndrome and in the follow-up of treated Cushing's diseases.
PATIENTS AND METHODS
These patients included 149 patients with Cushing's diseases, 20 with adrenal tumors, and 41 with ectopic ACTH/LPH syndromes. Hormone levels were measured before therapy and during the follow-up of treated Cushing's diseases.
RESULTS
ACTH and LPH plasma levels were moderately elevated in Cushing's diseases, low or undetectable in adrenal tumors, and highly elevated in ectopic ACTH/LPH syndromes, but the overlap between the three etiologic groups was less for LPH than for ACTH. LPH appeared to be as sensitive as ACTH in evaluating the outcome of trans-sphenoidal surgery and in detecting the occurrence of Nelson's syndrome after bilateral adrenalectomy.
CONCLUSION
Therefore, plasma LPH determinations provide a better index than ACTH measurements, probably for technical reasons as well as because of the greater stability of LPH in blood.
目的
在单一中心对210例库欣综合征患者进行评估，以评估促肾上腺皮质激素（ACTH）和促脂素（LPH）血浆水平在库欣综合征病因诊断及治疗后的库欣病随访中的相对价值。
患者与方法
这些患者包括149例库欣病患者、20例肾上腺肿瘤患者和41例异位ACTH/LPH综合征患者。在治疗前及治疗后的库欣病随访期间测量激素水平。
结果
库欣病患者的ACTH和LPH血浆水平中度升高，肾上腺肿瘤患者的水平低或无法检测到，异位ACTH/LPH综合征患者的水平则显著升高，但LPH在三个病因组之间的重叠程度小于ACTH。在评估经蝶窦手术的结果以及检测双侧肾上腺切除术后尼尔森综合征的发生方面，LPH似乎与ACTH一样敏感。
结论
因此，血浆LPH测定比ACTH测量提供了更好的指标，这可能是由于技术原因以及LPH在血液中的稳定性更高。
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