JCEM:库欣综合征患者的海马体积、认知功能、抑郁、焦虑和生活质量分析

2019-06-20 xing.T MedSci原创

由此可见,目前的研究并未提示CS患者的海马体积减少。然而,大多数患者认知领域受到显著影响,并且对手术反应良好。CS患者出现抑郁症状和HRQoL降低,术后有所改善。

库欣综合征(CS)与海马萎缩和精神病理学有关。近日,内分泌和代谢性疾病领域权威杂志Journal of Clinical Endocrinology & Metabolism上发表了一篇研究文章,该系统评价的主要目的是评估CS患者的海马体积。次要目标是评估CS患者的认知功能、抑郁和焦虑症状以及生活质量(QoL)。

研究人员检索了PubMed、Embase、Cochrane、LILACs和Scopus数据库中于2019年5月1日之前发表的相关研究。目前的研究包括病例对照研究,比较CS患者与健康对照,或评估手术前后CS患者的研究。最初的检索有18项研究符合纳入标准。所有结果的数据提取由两位评价员独立完成。研究人员通过使用Newcastle-Ottawa量表进行病例对照研究评估质量评估,并使用随机效应模型进行Meta分析。

与健康对照相比,CS患者右侧海马体积减少了0. 68 SMD(95%CI为-1.12至-0·24; p=0.002; I2=0%),但手术后的海马体积没有增加。CS患者表现出更多抑郁症状,认知功能受损以及与健康相关的QoL(HRQoL)降低,这些都对手术反应良好。该数据不支持CS患者出现焦虑。 

由此可见,目前的研究并未提示CS患者的海马体积减少。然而,大多数患者认知领域受到显著影响,并且对手术反应良好。CS患者出现抑郁症状和HRQoL降低,术后有所改善。 

原始出处:

Oludamilola W Oluleye,et al.Hippocampal volume, cognitive functions, depression, anxiety, and quality of life in patients with Cushing’s syndrome.J Clin Endocrinol Metab. 2019.https://doi.org/10.1210/jc.2019-00749

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    2020-01-26 achengzhao
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    2020-05-28 smallant2015
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    2019-06-20 明天jing

    焦虑是当年年轻人的共同问题,需要认真对待。

    0

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28岁女性,因“皮肤紫纹、血压升高伴宫内孕5个月余”入院。经鉴别诊断,患者为库欣综合征肾上腺腺瘤合并妊娠。据悉,到2004年,通过查询Cochrane图书馆(cochrane ibrary)和PubMed,全球只报道库欣综合征合并妊娠136例。对于此病如何进行诊断?又该如何进行治疗?

Lancet Diabetes Endocrinol:库欣综合征药物治疗前沿进展

20世纪50年代,因为缺乏有效治疗手段,库欣综合征患者的平均存活仅4.6年。半个多世纪后的今天,随着医学知识和技术的不断更新和飞速发展,库欣综合征患者的寿命得到大幅延长,但死亡率仍是正常人群的1.7~4.8倍。及时诊断和治疗库欣综合征非常重要。2018年7月,发表在《Lancet Diabetes Endocrinol》的一篇综述对库欣综合征药物治疗最新进展情况进行了阐述。

J Clin Endocrinol Metab:高危人群库欣氏综合征筛查模型:前瞻性多中心研究

背景:库欣综合征(CS)是具有挑战性的诊断。随着特定人群CS发病率的增加,但是对CS的常规筛查仍具有种种问题。为了减少延迟诊断和改善疾病预后,在高危人群中进行新的简单的CS筛查方法是必要的。目的:基于临床症状和生化结果,开发和验证一个简单的评分系统,预测CS。方法:观察性、前瞻性、多中心研究纳入了353例患者。所有患者均进行深夜唾液皮质醇(LNSC)和小剂量地塞米松抑制试验(DST)。以诊断或排除