探讨血细胞、电解质在库欣病的诊断和手术疗效中的价值

Blood cell and electrolyte change in diagnosis and surgical treatment of Cushing＇s disease

目的 探讨血细胞、电解质在库欣病（Cushing’s disease，CD）患者中的诊断与治疗的价值。方法以2003年1月至2010年12月经病理证实为垂体促肾上腺皮质激素腺瘤的116例CD和肾上腺皮质腺瘤（adrenoeorticaladenoma，ACA）的21例为研究对象，分别行经鼻蝶窦垂体腺瘤切除术（TSS）和后腹腔镜下肾上腺腺瘤切除术。按CD缓解标准分为手术缓解组（A组）、未缓解组（B组），及肾上腺腺瘤组（C组）。收集并比较A、B、c3组术前、术后即时的血细胞和电解质水平的变化。结果cD和ACA患者术前的血细胞、电解质水平均异常，且A组其术前与术后的即时水平比较有显著性差异；而B、C组则无显著性改变；血细胞、电解质变化可有效提示CD病患者TSS手术疗效。结论TSS手术可改善CD术前血细胞、电解质的异常水平；相比耗费大、检测条件要求苛刻的内分泌学项目，血细胞、电解质的变化利于评估手术疗效和临床诊断；B、C组术前、术后无明显差异，提示血细胞、电解质对ACA和未缓解的CD无明确价值，认为对cs的诊断和治疗大有裨益。

Objective To evaluate the diagnostic significance of blood cells and electrolyte in preoperative diagnosis and surgical treatnlent of Cushing＇s disease （CD）. Methods 116 csses of CD and 21 cases of adrenocortical adenoma （ACA） patients pathologically proven adrenocortieotropic hormone （ACTH） adenoma from Jan. 2003 to Dec. 2010 were enrolled into the study. They were given transsphenoidal surgery （TSS） and laparoseopie resection of adrenal adenoma （LRAA）. Patients were divided into remission group （group A ） , non-remission group （ group B） and ACA group （ group C） according to the remission criteria of CD. The preoperative and postoperative level of blood ceils and electrolyte were determined. Results TSS treatment improved the abnormal level of blood cells and electrolyte in patients with CD. Group A had significant change in preoperative and postoperative level of blood cells and electrolyte, while group B and group C didn＇t. Conclusions Compared with the endocrine examination items which need huge expense and harsh conditions, the change of blood cells and electrolyte level is more superior in assessing diagnostic and cruative effects on CD patients.