小剂量地塞米松抑制试验在库欣综合征疾病诊断中应用研究.docVIP

小剂量地塞米松抑制试验在库欣综合征疾病诊断中应用研究 　　[摘要] 目的 探讨研究小剂量地塞米松抑制试验对库欣综合征的诊断方法。方法 整群选取2012年1月―2015年1月间在该院诊治经临床诊断证实的库欣综合征老年患者34例作为研究对象，选择同期行健康体检的30例健康体检患者作为对照组，记录患者基础8点血清皮质醇水平及2 mgDST后血清皮质醇绝对值，计算其抑制率。分别以血清皮质醇绝对值和抑制率作为2 mgDST对库欣综合征诊断切点，分析两方法与患者术后病理学诊断的符合率，评价诊断准确性。结果 血清皮质醇以及24 h尿游离皮质醇数值结果显示，所有患者均表现为8点和24点的血清皮质醇水平升高，且昼夜节律消失。2 mgDST结果 观察组2 mgDST后8点血清皮质醇的水平明显下降，与基础8点比较差异有统计学意义（P5 Lg/dL和抑制率5 Lg/dL为切点诊断库欣综合征的方法准确性更高，因此针对老年库欣综合征患者，采用小剂量地塞米松抑制试验具有更高的诊断应用价值。 　　[关键词] 小剂量地塞米松抑制试验；库欣综合征；糖皮质激素 　　[中图分类号] R586 [文献标识码] A [文章编号] 1674-0742（2015）08（c）-0147-02 　　Application of Tests in Diagnosis of Cushings Syndrome in the Low-dose Dexamethasone Suppression 　　LI Wei， LIU Ren-gong， ZHANG Zhi-nong 　　Department of Endocrinology， Qiqihar First Hospital， Qiqihar， Heilongjiang Province， 161000 China 　　[Abstract] Objective To investigate the study of low-dose dexamethasone test diagnosis of Cushings syndrome is suppressed. Methods Selected from January 2012 to January 2015 in the hospital，34 cases of elderly patients as research subjects， concomitant healthy selection of 30 healthy patients as a control group， 8：00 records the patients basic serum cortisol levels and serum cortisol after 2 mgDST absolute value calculate the inhibition rate. Respectively， and the absolute value of serum cortisol suppression rate as 2 mgDST diagnosis of Cushings syndrome cut-off point， Serum cortisol and urinary free cortisol 24 h numerical results showed that all patients showed serum cortisol levels 8：00 and 24 points increased， and the circadian rhythm disappeared. Results The 2 mgDST after 8：00 serum cortisol levels decreased， with statistical significance （P 5Lg / dL and inhibition rate and 2mgDST inhibitory rate 5Lg / dL as the cutoff point higher diagnostic accuracy method of Cushings syndrome， so for elderly patients with Cushings syndrome， the use of low-dose dexamethasone suppression diagnostic test has a higher value. 　　[Key words] Low-dose dexamethasone suppression test； Cushings syndrome； Glucocorticoids