选择性静脉采血在促肾上腺皮质激素（ACTH）依赖性库欣综合征诊断中的应用经验。
Experience with selective venous sampling in diagnosis of ACTH-dependent Cushing's syndrome.
作者信息
Drury P L, Ratter S, Tomlin S, Williams J, Dacie J E, Rees L H, Besser G M
出版信息
Br Med J (Clin Res Ed). 1982 Jan 2;284(6308):9-12. doi: 10.1136/bmj.284.6308.9.
Abstract
Twenty-three patients with adrenocorticotrophic hormone-(ACTH)-dependent Cushing's syndrome were subjected to selective venous catheterisation and sampling for ACTH on a total of 26 occasions. Out of 10 patients with pituitary-dependent disease, nine had raised ACTH concentrations in one or both high internal jugular vein samples. Eight patients had 11 proved sites of ectopic hormone production: of these, six were correctly identified by the sampling technique, and in four of them this was the only accurate method of localisation. The results of one catheterisation were misleading, and on 10 occasions they were inconclusive; five patients remained undiagnosed by any method. Overall, 15 of the 26 catheterisations provided diagnostically valuable information. Selective venous catheterisation and sampling for ACTH is effective in confirming a pituitary source of the hormone and may be valuable in locating the source of ectopic ACTH production in some cases.
摘要
23例促肾上腺皮质激素（ACTH）依赖性库欣综合征患者共接受了26次选择性静脉插管及ACTH采样。10例垂体依赖性疾病患者中，9例一侧或双侧颈内静脉高位样本中的ACTH浓度升高。8例患者证实存在11个异位激素产生部位：其中6个通过采样技术被正确识别，且在4例中这是唯一准确的定位方法。1次插管结果产生误导，10次结果无定论；5例患者通过任何方法均未确诊。总体而言，26次插管中有15次提供了有诊断价值的信息。选择性静脉插管及ACTH采样对于确认激素的垂体来源有效，且在某些情况下可能有助于定位异位ACTH的产生部位。
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