第一节皮质醇症（First episode of cortisol）.docVIP

第一节皮质醇症（First episode of cortisol） Due to the continuous improvement of diagnostic techniques, the detection rate of incidental adrenal tumors without clinical manifestations is increasing, and the localization rate of adrenal tumors is also improved. In the surgical treatment of adrenal diseases, still with Cushings syndrome, primary aldosteronism and hypercatecholaminism the most common metastatic adrenal carcinoma also receivedtakes than primary cortical carcinoma is more common, is of clinical importance. First episode of cortisol Cortisol, known as Cushings syndrome (Cushing, 5, syndrome), is a series of typically complex symptoms due to the chronic excess of glucocorticoids in the body. According to the causes of Cushings disease, ACTH is divided into two categories: ACTH dependent and non dependent: 1. ACTH dependent hypercortisolism (corticotropin - dependent Cushing 5 syndrome) including: the lesions in the pituitary or hypothalamus, accounting for 70% of the 80%, because of adenoma or hyperplasia of excessive secretion of ACTH stimulated adrenal hyperplasia. If adenoma, the operation should be performed by the Department of Neurosurgery, the effect is satisfactory. If the tissue hyperplasia, radiotherapy can be pituitary, but the efficacy is not satisfactory. The ectopic ACTH syndrome (ectopic corticotropic syndrome) (15%) is due to some diseases such as lung cancer, pancreatic cancer, breast cancer, bronchial adenoma or pheochromocytoma and ectopic hypersecretion induced by ACTH, the method of treatment is resection of tumor. 2. non ACTH dependent hypercortisolism (corticotropi, independent Cushing 5 syndrome) due to large amounts of cortisol secretion by the adrenal cortex adenoma or adenocarcinoma (accounted for 15% for several high levels of cortisol in the blood feedback inhibition of pituitary secretion of ACTH, so that no lesions in adrenal cortex atrophy. Nodular adrenal hyperplasia (nodular, adrenal, hyperplasia) is a special type. Pathogenesis ma