【摘要】：目的:了解POEMS綜合征患者合并的內(nèi)分泌異常的特點(diǎn),為在合并內(nèi)分泌系統(tǒng)異常的患者中識(shí)別出POEMS綜合征的高危人群提供依據(jù)。方法:以"POEMS綜合征"為詞檢索北京大學(xué)人民醫(yī)院病案數(shù)據(jù)庫,共納入23例患者。使用Epidata 3.0軟件進(jìn)行數(shù)據(jù)錄入,SPSS 19.0統(tǒng)計(jì)軟件進(jìn)行數(shù)據(jù)分析。結(jié)果:入組患者平均年齡47歲,男女比例為1.88∶1,首發(fā)癥狀以多發(fā)神經(jīng)病變(56.5%)最為多見,從首發(fā)癥狀至確診的中位時(shí)間為30個(gè)月。就診于神經(jīng)內(nèi)科的患者例數(shù)最多,診斷的中位時(shí)間最短�；颊吒黜�(xiàng)臨床表現(xiàn)的發(fā)生率分別為多發(fā)神經(jīng)病變100.0%、器官腫大82.6%、內(nèi)分泌異常95.7%、漿細(xì)胞克隆性增生52.2%、皮膚改變91.3%,臨床體征有視乳頭水腫45.5%、血管外負(fù)荷增加43.5%、血小板升高43.5%、Castleman病17.4%。在內(nèi)分泌系統(tǒng)異常中,泌乳素水平異常的發(fā)生率最高,為60.0%,其次分別為甲狀腺軸及腎上腺軸功能異常。在內(nèi)分泌系統(tǒng)受累的患者中,2個(gè)靶腺受累的發(fā)生率最高,占36.5%。結(jié)論:內(nèi)分泌系統(tǒng)異常是POEMS綜合征常見的臨床表現(xiàn),對(duì)于甲狀腺、腎上腺、性腺、甲狀旁腺功能異常者以及泌乳素水平或糖耐量異常者,尤其是累及2個(gè)或2個(gè)以上的內(nèi)分泌系統(tǒng)功能異常者,應(yīng)提高警惕,關(guān)注多發(fā)神經(jīng)病變的癥狀和體征,減少POEMS綜合征的誤診、漏診,同時(shí),對(duì)POEMS綜合征患者需全面評(píng)估各個(gè)內(nèi)分泌系統(tǒng)的異常,以使患者得以及時(shí)的診斷和治療。
[Abstract]:Aim: to investigate the characteristics of endocrine abnormalities in patients with POEMS syndrome and to provide evidence for identifying the high risk population of POEMS syndrome in patients with endocrine system abnormalities. Methods: "POEMS syndrome" was used to search the medical record database of Peking University people's Hospital, and 23 patients were included in the database. Epidata 3.0 software was used for data entry and SPSS 19.0 software was used for data analysis. Results: the average age of the patients in the group was 47 years, the ratio of male and female was 1.88%, the most common first symptom was multiple neuropathy (56.5%), and the median time from the first symptom to the diagnosis was 30 months. The number of patients visited the neurology department was the most and the median diagnosis time was the shortest. The incidence of multiple neuropathy, organ enlargement, endocrine abnormality, plasma cell clonality and skin change were 100.0%, 82.6%, 95.7%, 52.2% and 91.3%, respectively. The clinical signs were papillary edema (45.5%), extravascular load (43.5%), platelet (43.5%) and Castleman's disease (17.4%). Among the endocrine system abnormalities, the incidence of abnormal prolactin level was the highest (60.0%), followed by thyroid axis and adrenal axis dysfunction. Among the patients with endocrine system involvement, the incidence of two target glands was the highest, accounting for 36.5%. Conclusion: abnormal endocrine system is a common clinical manifestation of POEMS syndrome. For those with abnormal thyroid, adrenal, gonadal, parathyroid function, and abnormal prolactin level or glucose tolerance, Especially for those with two or more abnormal endocrine system function, we should pay more attention to the symptoms and signs of multiple neuropathy, reduce the misdiagnosis and missed diagnosis of POEMS syndrome, and at the same time, we should pay more attention to the symptoms and signs of multiple neuropathy. In order to diagnose and treat POEMS syndrome, it is necessary to evaluate the abnormalities of each endocrine system in an all-round way.
【作者單位】： 北京大學(xué)人民醫(yī)院內(nèi)分泌科;
【分類號(hào)】：R597

【相似文獻(xiàn)】

相關(guān)期刊論文 前10條

1 劉幼碩;老年人內(nèi)分泌系統(tǒng)特點(diǎn)與疾病[J];中華老年醫(yī)學(xué)雜志;2005年08期

2 嚴(yán)濤世;內(nèi)分泌系統(tǒng)疾病外科部分[J];護(hù)士進(jìn)修雜志;1988年05期

3 王建華;;內(nèi)分泌系統(tǒng)[J];家庭醫(yī)學(xué)(下半月);2012年02期

4 楊久紅;趙璐璐;;淺談內(nèi)分泌疾病的治療[J];中國(guó)衛(wèi)生產(chǎn)業(yè);2012年06期

5 周肅;;內(nèi)分泌疾病與遺傳(二)[J];天津醫(yī)藥;1984年01期

6 陳家偉;中華醫(yī)學(xué)會(huì)第二屆全國(guó)內(nèi)科學(xué)術(shù)會(huì)議專稿——Ⅻ.內(nèi)分泌學(xué)術(shù)論文簡(jiǎn)介[J];新醫(yī)學(xué);1987年12期

7 森昌朋;內(nèi)分泌疾病[J];日本醫(yī)學(xué)介紹;1999年11期

8 周玉林;;第十五講 內(nèi)分泌系統(tǒng)[J];中國(guó)社區(qū)醫(yī)師;1986年08期

9 任冬莉,王忠;淺談內(nèi)分泌系統(tǒng)心身疾病[J];醫(yī)學(xué)與哲學(xué);1997年07期

10 譚郁彬;內(nèi)分泌系統(tǒng)病理學(xué)回顧與展望[J];中華病理學(xué)雜志;1995年04期

相關(guān)會(huì)議論文 前2條

1 葉真;;內(nèi)分泌的若干進(jìn)展[A];2005年浙江省內(nèi)分泌學(xué)術(shù)會(huì)議論文匯編[C];2005年

2 王園;吉國(guó)力;陳承祺;李健;;復(fù)雜內(nèi)分泌系統(tǒng)的分析研究[A];科學(xué)發(fā)展觀與系統(tǒng)工程——中國(guó)系統(tǒng)工程學(xué)會(huì)第十四屆學(xué)術(shù)年會(huì)論文集[C];2006年

相關(guān)重要報(bào)紙文章 前5條

1 鄢盛愷 夏良裕 邱玲;內(nèi)分泌疾病常用的化驗(yàn)檢查有哪些[N];家庭醫(yī)生報(bào);2006年

2 中國(guó)中醫(yī)研究院西苑醫(yī)院教授 張國(guó)喜;關(guān)注老年人內(nèi)分泌系統(tǒng)的變化[N];家庭醫(yī)生報(bào);2009年

3 記者白毅;警惕藥物引起的內(nèi)分泌疾病[N];中國(guó)醫(yī)藥報(bào);2011年

4 山東 主任醫(yī)師 王有國(guó);內(nèi)分泌系統(tǒng)自述[N];家庭醫(yī)生報(bào);2005年

5 北京國(guó)際抗衰老醫(yī)學(xué)中心現(xiàn)代城會(huì)診中心 肖韌 本報(bào)記者 趙雪;抗衰老：調(diào)節(jié)內(nèi)分泌[N];科技日?qǐng)?bào);2002年

，

本文編號(hào)：2439868