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以肾上腺意外瘤为首诊原因的亚临床库欣综合征一例

The fast blood flow density of intermediate choroid in endogenous Cushing syndrome: analysis of optical coherence tomography angiography

ObjectiveTo compare the fast blood flow density (FBFD) of intermediate choroid between endogenous Cushing syndrome (ECS) patients and healthy control subjects.MethodsThirteen eyes of 7 eligible ECS patients (ECS group) and 13 eyes of 7 gender, age, axial length matched healthy volunteers (control group) were enrolled in this study. For each subject, macular radial scan with swept source optical coherence tomography (SS-OCT) was performed and subfoveal choroidal thickness (SCT) was measured. Then 3.0 mm×3.0 mm macular scan with SS-OCT angiography was performed, and selected blood flow image at intermediate choroid level or 1/2 SCT beneath Bruch membrane. The grayscale images were then binarized for the analysis of FBFD.ResultsThe SCT in ECS group was (394.7±77.7) μm, which was significantly thicker than (332.1±68.1) μm in control group (t=2.923, P=0.008). The FBFD of intermediate choroid in ECS group were (76.35±14.46)%, which were significantly greater than (63.57±13.42)% in control group (t=2.775, P=0.01).ConclusionECS patients had increased FBFD at intermediate choroid level compared with healthy controls.

妊娠合并库欣综合征一例

库欣综合征伴足溃疡两例

库欣病合并肺栓塞一例并文献复习

目的 总结分析库欣综合征（Cushing syndrome，CS）合并静脉血栓栓塞症（venous thromboembolic events，VTE）的发病机制、临床风险评估及治疗，提高临床医师对此并发症的认识。方法 报道1例库欣病（Cushing disease，CD）合并肺栓塞患者的临床诊治经过，并复习国内外相关文献。结果 患者31岁，女性，确诊CD，行鞍区占位切除术，术后第6天肺动脉血管三维重建增强计算机断层扫描（computed tomography angiography，CTA）提示肺栓塞，先后予以低分子肝素及利伐沙班抗凝治疗，3个月后复查肺动脉CTA未见异常。以“库欣病、库欣综合征”与“肺栓塞、静脉血栓栓塞症”为关键词检索万方医学数据库、中国知网医学数据库和维普网数据库，国内仅3篇相关文献。检索pubmed数据库，共检索到相关文献73篇其中28篇个案报道，10篇综述，35篇临床研究文章。CS发生VTE风险比普通人群高10余倍，发病机制及临床风险评估复杂，预防抗凝时间及方案尚未达成共识。结论 CS发生VTE的风险显著升高，起病急，病死率高。临床上需警惕、避免、甄别CS相关并发症，做到早诊断、早治疗。