Tenschert W, Vetter H, Siebenschein R, Holland-Cunz B, Siegenthaler W, Vetter W
Schweiz Med Wochenschr. 1981 Jan 17;111(3):70-3.
The diagnostic results in 32 patients (23 female, 9 male) with Cushing's syndrome are presented. 20 patients had pituitary Cushing's syndrome (mean age 36.2 +/- 15.9 years), 7 unilateral adrenal adenoma (mean age 37.1 +/- 15.3 years) and 4 (mean age 54.8 +/- 10.8 years) carcinoma of one adrenal gland. One patient had an ectopic ACTH syndrome based on a Zollinger-Ellison syndrome. Hypertension was observed in 84% of the 32 patients. The basal urinary excretion rates were pathologically high in 99% of all measurements, while the excretion rates for 17-OH-steroids were pathologically elevated only in 61% of all measurements. Radioscanning of the adrenal glands was performed in 11 patients with 131I-cholesterol derivatives of NP-59. 4 patients with pituitary Cushing's syndrome had bilaterally increased uptake of activity, while 3 patients with adenoma had uptake of the radiolabeled drug on the side of the lesion. In all 4 patients with a carcinoma, uptake was absent or insufficient. The results show that measurement of the basal urinary excretion rate of free cortisol is a more sensitive means for detection of hypercorticism than measurement of 17-hydroxysteroids. Radioscanning of the adrenal glands provides reliable results in pituitary Cushing's syndrome and adenomas, but, in our cases, not in carcinomas.
本文呈现了32例库欣综合征患者（23例女性，9例男性）的诊断结果。20例患者患有垂体性库欣综合征（平均年龄36.2±15.9岁），7例患有单侧肾上腺腺瘤（平均年龄37.1±15.3岁），4例患有一侧肾上腺皮质癌（平均年龄54.8±10.8岁）。1例患者基于卓-艾综合征患有异位促肾上腺皮质激素（ACTH）综合征。32例患者中84%观察到高血压。所有测量中99%的基础尿排泄率病理升高，而17-羟类固醇的排泄率仅在所有测量的61%中病理升高。对11例患者用NP-59的131I-胆固醇衍生物进行肾上腺放射性扫描。4例垂体性库欣综合征患者双侧放射性摄取增加，而3例肾上腺腺瘤患者在病变侧有放射性标记药物摄取。所有4例肾上腺皮质癌患者均无摄取或摄取不足。结果表明，测定游离皮质醇的基础尿排泄率比测定17-羟类固醇是检测皮质醇增多症更敏感的方法。肾上腺放射性扫描在垂体性库欣综合征和肾上腺腺瘤中能提供可靠结果，但在我们的病例中，对肾上腺皮质癌则不然。
