Gülmez I, Keleştimur F, Durak A C, Ozesmi M
Department of Chest Disease, Erciyes University, Medical School, Kayseri, Turkey.
Endocr J. 1996 Oct;43(5):573-6. doi: 10.1507/endocrj.43.573.
Adrenal glands may be involved during both acute and chronic tuberculosis. They are enlarged in acute pulmonary tuberculosis. We aimed to investigate the changes in adrenal size in acute pulmonary tuberculosis before and after therapy in a prospective study. Eleven hospitalized patients with newly diagnosed sputum positive pulmonary tuberculosis were studied. Basal cortisol levels were measured in the patients before and after the therapy. Cortisol levels were also measured 30 and 60 min after Synacthen (250 micrograms i.v.) injection in the patients before the therapy. The size of the adrenal glands was measured by computerized tomography. The maximum width perpendicular to the long axis of the body of the gland, maximum width of the medial and lateral limbs and the length of the adrenals were measured. All measurements were done before and after the eight-month anti-tuberculosis therapy. All 11 patients had an intact adrenal cortisol reserve. Both the width and length of the right and left adrenal glands were significantly greater before the therapy than after the therapy. We conclude that adrenal enlargement demonstrated by computerized tomography in acute pulmonary tuberculosis is reduced after appropriate therapy.
肾上腺在急性和慢性结核病过程中都可能受累。在急性肺结核时肾上腺会增大。我们旨在通过一项前瞻性研究调查急性肺结核患者治疗前后肾上腺大小的变化。研究了11例新诊断为痰涂片阳性肺结核的住院患者。在治疗前后测量患者的基础皮质醇水平。在治疗前的患者中，还在静脉注射辛纳克肽（250微克）后30分钟和60分钟测量皮质醇水平。通过计算机断层扫描测量肾上腺的大小。测量垂直于腺体主体长轴的最大宽度、内侧和外侧肢体的最大宽度以及肾上腺的长度。所有测量均在8个月抗结核治疗前后进行。所有11例患者的肾上腺皮质醇储备均完整。治疗前左右肾上腺的宽度和长度均显著大于治疗后。我们得出结论，急性肺结核中计算机断层扫描显示的肾上腺增大在适当治疗后会减小。
