西藏地区25例肾上腺结核所致艾迪生病的回顾性分析及相关文献复习
A retrospective analysis of 25 cases of Addison's disease caused by adrenal tuberculosis in Tibet and review of related literature.
作者信息
Zeding Zhuoma, Liu Lin, Wang Chen, Tian Qing, Zhang JunQing, Zen Yan, Zhang Ni, Shen Jing, Na A Mi, BaSang PuChi, Lv XueMei, Yang SenLin, Meng ShuYou, Yang LiHui
机构信息
People's Hospital of Tibet Autonomous Region, Lhasa, China.
Peking University First Hospital, Beijing, China.
出版信息
J Clin Tuberc Other Mycobact Dis. 2023 Mar 6;31:100358. doi: 10.1016/j.jctube.2023.100358. eCollection 2023 May.
BACKGROUND
To investigate the clinical characteristics of Addison's disease caused by adrenal tuberculosis in Tibet. After the anti-tuberculosis treatment, the clinical features between continuous glucocorticoid therapy and glucocorticoid withdrawal were analyzed.
METHODS
Clinical data of patients with Addison's disease caused by adrenal tuberculosis diagnosed in The People's Hospital of Tibet Autonomous Region from January 2015 to October 2021 were collected and analyzed. All patients were taking anti-tuberculosis and glucocorticoids replacement therapy, and the root cause of the disease was analyzed following prognosis observations.
RESULTS
There were 25 patients (24 Tibetan and 1 Han patient) with Addison's disease caused by adrenal tuberculosis, including 18 males and 7 females. A total of 21 cases were followed up successfully, of which 13 cases discontinued anti-tuberculosis drugs successfully, 6 cases discontinued glucocorticoid therapy among the rest, 6 cases continued anti-tuberculosis + glucocorticoid replacement therapy, and 2 cases died.
CONCLUSION
Early diagnosis and proper anti-tuberculosis treatment can improve the prognosis of patients with adrenal tuberculosis. Moreover, screening and educating Tibetan people regarding the potential risk and adversities of adrenal tuberculosis is crucial for eradicating the disease.
背景
探讨西藏地区肾上腺结核所致艾迪生病的临床特征。在抗结核治疗后，分析持续糖皮质激素治疗与停用糖皮质激素后的临床特点。
方法
收集2015年1月至2021年10月在西藏自治区人民医院确诊的肾上腺结核所致艾迪生病患者的临床资料并进行分析。所有患者均接受抗结核及糖皮质激素替代治疗，并在预后观察后分析病因。
结果
有25例肾上腺结核所致艾迪生病患者（24例藏族、1例汉族），其中男性18例，女性7例。共21例成功随访，其中13例成功停用抗结核药物，其余6例停用糖皮质激素治疗，6例继续抗结核+糖皮质激素替代治疗，2例死亡。
结论
早期诊断和恰当的抗结核治疗可改善肾上腺结核患者的预后。此外，对藏族人群进行肾上腺结核潜在风险和危害的筛查及教育对根除该病至关重要。
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