肾上腺皮质功能减低症的临床分析

Clinical analysis on chronic adrenocortical hypofunction

目的探讨慢性肾上腺皮质功能减低的病因及临床特点。方法回顾性分析肾上腺皮质功能减低的46例患者其发病原因及临床特点。结果 46例患者肾上腺皮质功能减低的原因依次为结核(16例)、特发性(14例)、垂体性(11例)、恶性肿瘤转移(3例)、肾上腺切除(1例)及其他(1例);常见的肾上腺皮质功能减低的表现依次为乏力(44例9,5.7%),消化道不适(38例8,2.6%),皮肤色素沉着(20例,43.5%),反复低血糖(21例4,5.7%),体位性低血压(20例4,3.5%),性欲减退、腋毛、阴毛脱落(18例,39.1%)。原发性肾上腺皮质功能减低的患者几乎均有皮肤色素沉着。结论慢性肾上腺皮质功能减低症最常见的原因是结核,故应注意结核的防治,其临床表现以乏力、消化道症状最为多见,病情重者出现皮肤色素沉着、低血糖、低血压及性欲减退、腋毛、阴毛脱落等。

Objective To summarize the etiology and clinical characteristics of patients with chronic adrenocortical hypofunction.Methods The clinical data of 46 patients with chronic adrenocortical hypofunction who were hospitalized in Affiliated Hospital of Ningxia Medical University from Jan.2002 to Dec.2010 were retrospectively analyzed.The median onset age was 53 years（ranged from 22 to 70 years old）.Results The main causes of chronic adrenocortical hypofunction were tuberculosis（n=16,34.8%）,and autoimmune factors（n=14,30.4%）,the third reason was pituitary problems.Malignant tumors and adrenalectomy were less in our study.The common clinical manifestations included fatigue in 44 cases（95.7%）,gastrointestinal system syndrome in 38 cases（82.6%）,skin pigmentation in 20 cases（43.5%）,hypoglycemia in 21 cases（45.7%）,hypotension in 20 cases（43.5%） and erectile dysfunction in 18 cases（39.1%）.Conclusion The most common causes that results in chronic adrenocortical hypofunction are tuberculosis and autoimmune factor.Fatigue and gastrointestinal system syndrome are most common manifestation of chronic adrenocortical hypofunction.