Chinese General Practice ›› 2022, Vol. 25 ›› Issue (20): 2435-2442.DOI: 10.12114/j.issn.1007-9572.2022.0190
Special Issue: 指南/共识最新文章合集
• Guide Interpretation • Next Articles
Received:
2022-02-15
Revised:
2022-03-20
Published:
2022-07-15
Online:
2022-05-19
Contact:
Yerong YU
About author:
通讯作者:
余叶蓉
作者简介:
基金资助:
Add to citation manager EndNote|Ris|BibTeX
URL: https://www.chinagp.net/EN/10.12114/j.issn.1007-9572.2022.0190
检查项目 | 灵敏度(%) | 特异度(%) | 优、缺点 | |
---|---|---|---|---|
CS诊断指标 | ||||
1 mg-DST | 98 | 81 | 优点:阴性预测值高;易于医疗人员管理 缺点:假阳性率高;地塞米松代谢可影响测定结果;其他药物干扰 | |
24 hUFC | 91.0 | 81.5 | 优点:参考范围广 缺点:操作繁琐;样本之间的多变性可能为50%,需要留取2~3个样本 | |
LNSC | 97.0 | 97.5 | 优点:患者易于操作;应提醒患者在收集唾液样本15 min前不要进食、饮水、吸烟或刷牙 缺点:多变性;根据参考实验室的不同,临界值会有很大的不同;可能被局部氢化可的松污染;并非所有中心均能检测 | |
CD复发监测 | ||||
LNSC | 75~90 | 93~95 | 优点:多数患者LNSC的异常早于DST和24 hUFC的异常 缺点:多变性;易出现正常或阴性结果 | |
24 hUFC | 68 | 100 | 优点:相对便捷 缺点:大约50%存在变异;容易受体积计量影响而导致异常结果 | |
DDAVP刺激试验 | 68 | 95 | 优点:可预测存在促肾上腺皮质激素腺瘤;临床腺瘤复发前可以变阳性 缺点:多次采血,动态密集检测 | |
1 mg-DST | NA | NA | 优点:可能会在24 hUFC之前出现异常 缺点:评估复发效用方面的证据有限 |
Table 1 Laboratory tests for Cushing's syndrome diagnosis and monitoring for Cushing's disease recurrence
检查项目 | 灵敏度(%) | 特异度(%) | 优、缺点 | |
---|---|---|---|---|
CS诊断指标 | ||||
1 mg-DST | 98 | 81 | 优点:阴性预测值高;易于医疗人员管理 缺点:假阳性率高;地塞米松代谢可影响测定结果;其他药物干扰 | |
24 hUFC | 91.0 | 81.5 | 优点:参考范围广 缺点:操作繁琐;样本之间的多变性可能为50%,需要留取2~3个样本 | |
LNSC | 97.0 | 97.5 | 优点:患者易于操作;应提醒患者在收集唾液样本15 min前不要进食、饮水、吸烟或刷牙 缺点:多变性;根据参考实验室的不同,临界值会有很大的不同;可能被局部氢化可的松污染;并非所有中心均能检测 | |
CD复发监测 | ||||
LNSC | 75~90 | 93~95 | 优点:多数患者LNSC的异常早于DST和24 hUFC的异常 缺点:多变性;易出现正常或阴性结果 | |
24 hUFC | 68 | 100 | 优点:相对便捷 缺点:大约50%存在变异;容易受体积计量影响而导致异常结果 | |
DDAVP刺激试验 | 68 | 95 | 优点:可预测存在促肾上腺皮质激素腺瘤;临床腺瘤复发前可以变阳性 缺点:多次采血,动态密集检测 | |
1 mg-DST | NA | NA | 优点:可能会在24 hUFC之前出现异常 缺点:评估复发效用方面的证据有限 |
[1] |
|
[2] |
|
[3] |
|
[4] |
|
[5] |
|
[6] |
|
[7] |
|
[8] |
|
[9] |
|
[10] |
|
[11] |
李佳琦,孙丽思,余叶蓉. 库欣综合征筛查试验的选择和临床应用[J]. 国际内分泌代谢杂志,2021,41(6):573-577. DOI:10.3760/cma.j.cn121383-20210831-08083.
|
[12] |
|
[13] |
|
[14] |
|
[15] |
|
[16] | |
[17] |
|
[18] |
|
[19] |
|
[20] |
|
[21] |
|
[22] |
|
[23] |
|
[24] |
|
[25] |
|
[26] |
|
[27] |
|
[28] |
|
[29] |
|
[30] |
|
[31] |
|
[32] |
茅江峰,柴晓峰,刘丽萍,等. 外周DDAVP兴奋试验在促肾上腺皮质激素依赖性库欣综合征鉴别诊断中的价值[J]. 中国实用内科杂志,2014,34(10):1000-1003.
|
[33] |
张微微,余叶蓉,谭惠文,等. 精氨酸血管加压素刺激试验与大剂量地塞米松抑制试验在库欣病与异位促肾上腺皮质激素综合征诊断中的价值[J]. 中华医学杂志,2016,96(11):845-849. DOI:10.3760/cma.j.issn.0376-2491.2016.11.004.
|
[34] |
|
[35] |
|
[36] |
|
[37] |
|
[38] |
|
[39] |
|
[40] |
|
[41] |
|
[42] |
|
[43] |
|
[44] |
|
[45] |
|
[46] |
|
[47] |
|
[48] |
|
[49] |
|
[50] |
|
[51] |
|
[52] |
|
[53] |
|
[54] |
|
[55] |
|
[56] |
朱蕾蕾,余叶蓉,肖珍,等. 清晨血皮质醇及促肾上腺皮质激素水平用作库欣病经蝶术后缓解标准的临床价值[J]. 四川大学学报:医学版,2019,50(2):260-263. DOI:10.13464/j.scuxbyxb.2019.02.024.
|
[57] |
|
[58] |
|
[59] |
|
[60] |
|
[61] |
|
[62] |
|
[63] |
|
[1] | LI Qianqian, CHEN Xunrui, ZHANG Wenying, YUAN Haihua, ZHANG Yanjie, JIANG Bin, LIU Feng. Demand and Influencing Factors for Community Health Services during Chemotherapy of Patients with Advanced Cancer [J]. Chinese General Practice, 2023, 26(33): 4173-4180. |
[2] | ZHOU Yuyu, GAO Chuan, CUI Puan, WANG Yaping, HE Zhong. Influencing Factors of Shared Decision Making between Doctors and Patients in Menopausal Hormone Therapy in Patients with Menopausal Syndrome [J]. Chinese General Practice, 2023, 26(33): 4181-4186. |
[3] | SU Kaiqi, LYU Zhuan, WU Mingli, LUO Meng, GAO Jing, NIE Chenchen, LIU Hao, FENG Xiaodong. Effect of Electroacupuncture on BDNF/TrkB/PI3K/Akt Pathway and Hippocampal Neuronal Protection in Rats with Learning and Memory Impairment after Ischemia Reperfusion [J]. Chinese General Practice, 2023, 26(33): 4187-4193. |
[4] | WANG Xu, WEI Xu, ZHU Liguo, FENG Tianxiao, WANG Zhipeng, SHI Bin. Research Ideas of the Efficacy Mechanism and Prospect Analysis of Traditional Chinese Manipulative Therapy on Treating Spinal Degenerative Diseases with Combination of Medicine and Industry [J]. Chinese General Practice, 2023, 26(33): 4118-4124. |
[5] | ZHANG Ming, XU Jing, SUN Zhenhua, ZHAO Wenhao, MA Yingqian, ZHANG Jianqiao, SHEN Haiping. Improvement of Nutritional Status of Elderly Patients with Severe Obstruction Esophageal Carcinoma by Image-guided Photodynamic Therapy [J]. Chinese General Practice, 2023, 26(30): 3780-3784. |
[6] | YAN Ke, WEI Wanyi, DENG Wenzhao, SHEN Wenbin, LI Shuguang, DU Xingyu, ZHANG Xueyuan, YANG Jie, ZHU Shuchai. Long-term Prognosis Analysis and Influencing Factors of Concurrent Chemotherapy and Radio-therapy for Cervical and Upper Thoracic Esophageal Squamous Cell Carcinoma [J]. Chinese General Practice, 2023, 26(30): 3785-3790. |
[7] | YAN Ke, WEI Wanyi, LI Shuguang, YAO Weinan, DONG Jing, WANG Xiaobin, ZHANG Xueyuan, YANG Jie, SHEN Wenbin, ZHU Shuchai. Effect of Consolidation Chemotherapy on Prognosis of StageⅡ-Ⅲ Esophageal Squamous Cell Carcinoma Patients Treated with Definitive Concurrent Chemotherapy and Radio-therapy [J]. Chinese General Practice, 2023, 26(30): 3772-3779. |
[8] | PU Yu, ZHANG Jixiang, DONG Weiguo. Advances in Ferroptosis and Inflammatory Bowel Disease [J]. Chinese General Practice, 2023, 26(29): 3698-3703. |
[9] | WANG Qianqian, WANG Xiaohang, ZHOU Xiaoying, QIU Shanhu, SUN Zilin. Exercise is the Foundation of Weight Loss [J]. Chinese General Practice, 2023, 26(28): 3471-3476. |
[10] | PEI Bei, CHENG Lin, XU Lingyun. Effects of Different Neoadjuvant Chemotherapy Regimens on Immune Indicators and Tumor Microenvironment in HER-2-positive Breast Cancer Patients [J]. Chinese General Practice, 2023, 26(27): 3435-3440. |
[11] | SUN Xiaolei, LEI Xiaolong, LIN Jiasheng, LI Keliang, GUO Ao, ZHANG Xiaohui. Effect of High Intensity Laser Combined with Physiotherapy Scoliosis Specific Exercise Therapy on Ultrasound Morphology of Multifidus Muscles in Idiopathic Scoliosis Patients with Low Back Pain [J]. Chinese General Practice, 2023, 26(27): 3456-3462. |
[12] | YAO Junjie, SHANG Qiangqiang, WANG Yufeng, LI Jiahui, LIU Chang, PANG Tingting. Wearable Inertial Sensors-based Efficacy Evaluation of Comprehensive Traditional Chinese Medicine Therapy for Lumbar Disc Herniation Due to Qi-stagnation and Blood-stasis [J]. Chinese General Practice, 2023, 26(27): 3450-3455. |
[13] | LIANG Xuemei, WANG Rui, ZHAO Yuhuan, XU Tianjiao, WANG Wei, SUN Weidong. Transcranial Low-level Laser Therapy: a Novel Treatment for Depression [J]. Chinese General Practice, 2023, 26(27): 3335-3341. |
[14] | CHEN Xiaofen, CHEN Yuhan, MA Juan. Recent Strides in Novel Treatments for Inflammatory Bowel Disease [J]. Chinese General Practice, 2023, 26(27): 3349-3354. |
[15] | SU Guobin, LING Xitao, DUAN Ruolan, ZHANG La, XU Yuan, PENG Yu, HOU Haijing, LIU Xusheng, LU Fuhua. Selection of Therapeutic Drugs for COVID-19 Infection in Adults with Chronic Kidney Disease Based on Medical Evidence [J]. Chinese General Practice, 2023, 26(26): 3220-3229. |
Viewed | ||||||
Full text |
|
|||||
Abstract |
|
|||||