库欣综合征曾正陪课件_1.ppt

库欣综合征 曾正陪 北京协和医院内分泌科 库欣综合征的病因从激素分泌分类 库欣综合征(Cushing syndrome,皮质醇增多症) Since cortisol production by the adrenal glands is normally under the control of the pituitary (like the thyroid gland), overproduction can be caused by a tumor in the pituitary or within the adrenal glands themselves. 因垂体或肾上腺肿瘤分泌过多皮质醇所致的一组症候群 库欣病(Cushing disease) When a pituitary tumor secretes too much ACTH (Adrenal Cortical Tropic Hormone), it simply causes the otherwise normal adrenal glands to produce too much cortisol. This type of Cushings syndrome is termed Cushings Disease“. In this case, serum cortisol will be elevated, and, serum ACTH will be elevated at the same time.因垂体瘤分泌过多促肾上腺皮质激素(ACTH),刺激肾上腺分泌过多皮质醇所致的库欣综合征 库欣综合征的病因从病变部位分类 垂体瘤（Pituitary Adenomas）Pituitary adenomas cause most cases of Cushings syndrome. They are benign, or non-cancerous, tumors of the pituitary gland which secrete increased amounts of ACTH. Most patients have a single adenoma. This form of the syndrome, known as Cushings disease, affects women five times more frequently than men. 异位ACTH综合征(Ectopic ACTH Syndrome) Some benign or malignant (cancerous) tumors that arise outside the pituitary can produce ACTH. This condition is known as ectopic ACTH syndrome. Lung tumors cause over 50 percent of these cases. Men are affected 3 times more frequently than women. The most common forms of ACTH-producing tumors are oat cell, or small cell lung cancer, which accounts for about 25 percent of all lung cancer cases, and carcinoid tumors. Other less common types of tumors that can produce ACTH are thymomas, pancreatic islet cell tumors, and medullary carcinomas of the thyroid. 库欣综合征的病因从病变部位分类 肾上腺肿瘤(Adrenal Tumors) Sometimes, an abnormality of the adrenal glands, most often an adrenal tumor, causes Cushings syndrome. The average age of onset is about 40 years. Most of these cases involve non-cancerous tumors of adrenal tissue, called adrenal adenomas, which release excess cortisol into the blood.