A reappraisal of the medical therapy with steroidogenesis inhibitors in Cushing's syndrome
A reappraisal of the medical therapy with steroidogenesis inhibitors in Cushing's syndrome
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DOI：
10.1111/j.1365-2265.2012.04424.x
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发表时间：
2012-11-01
影响因子：
3.2
通讯作者：
Webb, Susan M.
中科院分区：
文献类型：
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作者：
Valassi, Elena;Crespo, Iris;Webb, Susan M.
目的 评估术前使用酮康唑 (KTZ) 和/或美替拉酮 (MTP) 治疗先前未经治疗的库欣综合征 (CS) 患者的效果。设计和患者 对 1983 年至 2010 年间在手术前接受类固醇生成抑制剂治疗的 62 名 CS 患者（85% ACTH 依赖）进行了回顾性研究。 T0 和 t1 定义了术前药物治疗的基线和结束。结果结果基于 t1 皮质醇增多症的临床和生化（正常 UFC）控制：CO 组（对照）包括 20 名患有皮质醇增多症且临床显着改善的患者 (32%)； NC组（未控制）30名（48%）患有持续性皮质醇增多症且症状未得到控制； PC 组（部分对照）有 12 名患者（19%），尽管使用了皮质醇，但临床上没有真正的改善。中位治疗持续时间为4个月（范围：130.7），KTZ和MTP的中位累积剂量为57个月（范围：3.6240）和120个月（范围：7.51215）。 CO 患者单独使用 KTZ 治疗的比例高于其他组（P 类似于
Objective To evaluate the outcome of preoperative therapy with ketoconazole (KTZ) and/or metyrapone (MTP) in previously untreated patients with Cushing's syndrome (CS). Design and patients Sixty-two patients with CS (85% ACTH dependent), treated with steroidogenesis inhibitors prior to surgery between 1983 and 2010, were retrospectively studied. T0 and t1 defined baseline and end of preoperative medical treatment. Results Outcomes were based upon clinical and biochemical (normal UFC) control of hypercortisolism at t1: group CO (controlled) included 20 patients (32%) with eucortisolism and significant clinical improvement; group NC (not controlled) 30 (48%) with persistent hypercortisolism and no control of symptoms; and group PC (partially controlled) 12 patients (19%) who despite eucortisolism had no real clinical improvement. Median duration of treatment was 4 similar to months (range: 130.7), and median cumulative dose of KTZ and MTP was 57 similar to g (range: 3.6240) and 120 similar to g (range: 7.51215). CO patients were treated more with KTZ alone than the other groups (P similar to