From 1984 to 1990, six patients with histologically and endocrinologically proven ectopic ACTH syndrome were treated in our department. The lesion in five patients was clinically evident, but in the other was occult. ...From 1984 to 1990, six patients with histologically and endocrinologically proven ectopic ACTH syndrome were treated in our department. The lesion in five patients was clinically evident, but in the other was occult. All lesions were located within the chest. Four were thvmic carcinoid and the other two were bronchial carcinoids. Most of the patients had typical clinical manifestations of Cushing’s syndrome. Laboratory tests including histopathological examination confirmed the diagnosis of ectopic ACTH syndrome. The treatment consisted of surgical removal of the mass supplemented by radiotherapy. The results showed that after treatment all patients had satisfactory remission. Two bronchial carcinoid patients have been living for 40 and 88 months respectively without recurrence. Among 4 thymic carcinoid patients, only one has been living with no tumor for 34 months. One patient had recurrence and the other 2 died 32 and 50 months after the treatment respectively. However, the symptoms of two thymic carci展开更多
目的探讨不同类型的促肾上腺皮质激素(ACTH)依赖性库欣综合征患者的凝血功能临床特点。方法回顾性分析2014年6月至2021年5月在郑州大学第一附属医院确诊的72例ACTH依赖性库欣综合征患者,其中库欣病(CD)患者56例,异位ACTH综合征(EAS)患...目的探讨不同类型的促肾上腺皮质激素(ACTH)依赖性库欣综合征患者的凝血功能临床特点。方法回顾性分析2014年6月至2021年5月在郑州大学第一附属医院确诊的72例ACTH依赖性库欣综合征患者,其中库欣病(CD)患者56例,异位ACTH综合征(EAS)患者16例,比较两组患者间的凝血功能相关指标和激素水平的差异;选择两组24 h尿游离皮质醇(24 h UFC)1000~2000 nmol的患者,比较其激素及凝血功能相关指标的差异。对所有患者的凝血功能相关指标与激素水平及年龄、病程、体质量指数(BMI)、血糖、血压等指标进行相关性分析。结果CD组不同时间血ACTH、皮质醇、24 h UFC水平及凝血酶时间和D二聚体水平均低于EAS组(P<0.05),活化部分凝血活酶时间(APTT)和纤维蛋白原高于EAS组(P<0.05);两组24 h UFC 1000~2000 nmol患者比较,CD组纤维蛋白原高于EAS组(P<0.05),凝血酶时间和D-二聚体均低于EAS组(P<0.05)。ACTH依赖性库欣综合征患者APTT与血ACTH(早8点)、24 h UFC、年龄和血糖均呈负相关;纤维蛋白原与24 h UFC呈负相关;D-二聚体与血皮质醇(早8点)、24 h UFC、年龄呈正相关;凝血酶时间与血ACTH、24 h UFC、血糖呈正相关,与病程呈负相关。结论ACTH依赖性库欣综合征的血液高凝状态主要表现在APTT的缩短和D-二聚体的升高,APTT的缩短主要与高ACTH和皮质醇有关,而D-二聚体升高不仅与高皮质醇相关,还与恶性肿瘤本身相关。EAS较CD更易出现高凝状态。展开更多
文摘From 1984 to 1990, six patients with histologically and endocrinologically proven ectopic ACTH syndrome were treated in our department. The lesion in five patients was clinically evident, but in the other was occult. All lesions were located within the chest. Four were thvmic carcinoid and the other two were bronchial carcinoids. Most of the patients had typical clinical manifestations of Cushing’s syndrome. Laboratory tests including histopathological examination confirmed the diagnosis of ectopic ACTH syndrome. The treatment consisted of surgical removal of the mass supplemented by radiotherapy. The results showed that after treatment all patients had satisfactory remission. Two bronchial carcinoid patients have been living for 40 and 88 months respectively without recurrence. Among 4 thymic carcinoid patients, only one has been living with no tumor for 34 months. One patient had recurrence and the other 2 died 32 and 50 months after the treatment respectively. However, the symptoms of two thymic carci
文摘目的探讨不同类型的促肾上腺皮质激素(ACTH)依赖性库欣综合征患者的凝血功能临床特点。方法回顾性分析2014年6月至2021年5月在郑州大学第一附属医院确诊的72例ACTH依赖性库欣综合征患者,其中库欣病(CD)患者56例,异位ACTH综合征(EAS)患者16例,比较两组患者间的凝血功能相关指标和激素水平的差异;选择两组24 h尿游离皮质醇(24 h UFC)1000~2000 nmol的患者,比较其激素及凝血功能相关指标的差异。对所有患者的凝血功能相关指标与激素水平及年龄、病程、体质量指数(BMI)、血糖、血压等指标进行相关性分析。结果CD组不同时间血ACTH、皮质醇、24 h UFC水平及凝血酶时间和D二聚体水平均低于EAS组(P<0.05),活化部分凝血活酶时间(APTT)和纤维蛋白原高于EAS组(P<0.05);两组24 h UFC 1000~2000 nmol患者比较,CD组纤维蛋白原高于EAS组(P<0.05),凝血酶时间和D-二聚体均低于EAS组(P<0.05)。ACTH依赖性库欣综合征患者APTT与血ACTH(早8点)、24 h UFC、年龄和血糖均呈负相关;纤维蛋白原与24 h UFC呈负相关;D-二聚体与血皮质醇(早8点)、24 h UFC、年龄呈正相关;凝血酶时间与血ACTH、24 h UFC、血糖呈正相关,与病程呈负相关。结论ACTH依赖性库欣综合征的血液高凝状态主要表现在APTT的缩短和D-二聚体的升高,APTT的缩短主要与高ACTH和皮质醇有关,而D-二聚体升高不仅与高皮质醇相关,还与恶性肿瘤本身相关。EAS较CD更易出现高凝状态。
