目的 探讨柯兴氏综合症患者的首发症状,分析皮质醇增多所致骨质疏松的临床特点,提高对骨痛、骨折为首发表现的柯兴氏综合症的认识,减少误诊率.方法 收集近10 a来收治的柯兴氏综合症患者28例,总结其首发症状以及主要临床特点;对28例患者的腰椎、股骨颈进行X线测定,用双能X线吸收仪进行骨密度检测,分析不同类型的柯兴氏综合症所致骨质疏松的临床特点.结果 (1)无论哪种类型的柯兴氏综合症,高血压是最常见的首发症状,占32.1%(9/28),骨折、骨痛占25%(7/28);(2)28例患者行X线检查,其中10例骨质疏松,6例肾上腺腺瘤,3例椎体或髋部骨折;对7例有骨折或骨痛症状的患者行骨密度检查提示骨质疏松.结论 柯兴氏综合症所致骨质疏松症与病因相关,肾上腺肿瘤引起的肾上腺依赖性柯兴氏综合症较垂体分泌ACTH肿瘤引起的柯兴病更易引起的骨质疏松.%Objective To improve the knowledge of Cushing's syndrome and reduce the misdiagnosis rate,we investigated the clinical manifestation of Cushing's Syndrome with primary symptom of osteoporosis characterized by bone pain and fractures. Methods 28 patients with Cushing's syndrome in recent 10 years were enrolled in this study. Their primary symptom and major clinical characteristics were summarized. The bone mineral density of lumbar vertebrae and femur neck was measured by dual-energy X-ray absorptiometry to analyze the clinical characteristics of different Cushing's syndrome induced osteoporosis. Results (1) There were 32.1％ (9/28) patients with hypertension as the primary symptom, and 25％ (7/28) with bone pain and fractures. (2)There were 10 patients with osteoporosis, 6 patients with adrenal adenoma, 3 patients with fractures in vertebral body and coax. 7 patients with bone pain and fractures were diagnosed as osteoporosis by bone mineral density examination. Conclusion Cushing's syndrome induced by adrenal adenoma may lead to more osteoporosis than ACTH tumor, suggesting Cushing's Syndrome-related osteoporosis is affected by the causation of hypercortisonism.
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