庫(kù)欣綜合征英文

匯報(bào)人:xxx20xx-04-03庫(kù)欣綜合征英文目錄CONTENCTCushing'sSyndromeBasicsEpiologyofCushing'sSyndromePathophysiologyofCushing'sSyndromeClinicalManifestationsofCushing'sSyndrome目錄CONTENCTDiagnosticEvaluationforCushing'sSyndromeDiagnosticChallengesinCushing'sSyndrome01Cushing'sSyndromeBasicsDefinitionCausesDefinitionandCausesCushing'ssyndrome,alsoknownashypercortisonism,isaconditioncausedbyprolongedexposuretohighlevelsofcortisolorotherglucocorticoidsThemostmoncauseisanadultlandtutorthatsecretsexceedcortisolOthercausesincludePituitaryGlandTumors,ElectopicACTHproducingTumors,andlongtermuseofgloucoporticoidmedicinesPhysicalchanges01Patientsmayexperienceweightgain,specificallyaroundthewaistandface("moonface"),thinkingoftheskin,easybruising,andpurplestripemarksEmotionalandcognitivesymptoms02Depression,anxiety,irritability,anddiversityconcentratingaremonOthersymptoms03Highbloodpressure,diabetes,osteoporosis,andincreasedriskofinfectionsmayalsooccurSignsandSymptomsPhysicalexamBloodandurinetestsImagingtestsDoctorswilllookforsignsofCushing'ssyndromesuchasobjectivity,purplestripemarks,andhighbloodpressureThesetestsmeasurecortisolandotherhomonelevelstoconfirmthediagnosisMRIorCTscansmaybeusedtolocatetubersorotherabnormalitiesintheadultorpsychiatriclandsDiagnosisandTests01020304SurgicalremovalMedicationRadiationtherapyLifestylechangesTreatmentOptionsThismaybeusedtoshrinktubersthatcannotberemovedurgentlyDrugsthatblockcortisolproductionoractionmaybeusedinsomecasesIfatuberiscausingthecondition,surgicalremovalisoftenthefirstlineoftreatmentHealthyeatinghabits,regularexercise,andstressmanagementcanhelpimprovesymptomsandoverallhealth02EpiologyofCushing'sSyndromeTheincidentrateofCushing'ssyndromeisrelativelylow,affectingapproximately1-2peoplepermillionperyearThevalidityofCushing'ssyndromeisestimatedtobe10-15casespermillionpopulation,withwomenbeingaffectedmoreofthemIncidentandPrevalenceValidityIncidentAgeGenderGeneticFactorsChronicStressRiskFactorsCushing'ssyndrometypicallyoccursinadultsaged20to50yearsold,althoughitcanaffectpeopleofanyageWomenaremoreliketodevelopCushing'ssyndromethanmen,witharatioofabout3:1SomestudiessuggestthatgeneticfactorsmayplayaroleinthedevelopmentofCushing'ssyndrome,althoughthespecificgenesinvolvedhavenotbeenidentifiedChronicstressmaycontributetothedevelopmentofCushing'ssyndromebyaffectingthefunctionoftheadultlandsPrognosisThediagnosisofCushing'ssyndromedependsontheunderlyingcause,severityofsymptoms,andresponsetotreatmentWithpropertreatment,manypatientscanachieveremovalandimprovetheirqualityoflifeMortalityratesThemoralityrateassociatedwithCushing'ssyndromeisgenerallylowHowever,ifleftunrealizedoriftheunderlyingcauseismultiple,theconditioncanleadtoseriousplicationsandincreasedriskofdeathPrognosisandMortalityRatesPhysicalAppearanceCushing'ssyndromecancausephysicalchangessuchasweightgain,roundface(moonface),andskinchanges(suchasacneandstretchmarks)thatcanaffectaperson'sappearanceandself-examinationEmotionalwellbeingThephysicalandemotionalsymbolsofCushing'ssyndromecanleadtoanxiety,depression,andotheremotionaldifferencesthatcanimpactaperson'soverallwellbeingSocialImpactThevisiblephysicalchangescausedbyCushing'ssyndromecanleadtosocialisolationandsigma,whichcanfurtheraffectaperson'squalityoflifeQualityofLifeConsiderationsTreatmentBurdenThetreatmentforCushing'ssyndromecanbeplexandburdensome,requiringfrequentmedicalappointments,treatments,andpotentialsurgeriesThiscanaddtothestressandanxietyexperiencedbypatientsQualityofLifeConsiderations03PathophysiologyofCushing'sSyndromeElevatedCortisolLevelsCushing'ssyndromeischaracterizedbychronicallyelevatedlevelsofcortisol,ahormoneproducedbytheadultglandsThisexcesscortisolcandisruptnormalhormonalbalancesandleadtothedevelopmentofthecondition'scharacteristicsignsandsymptomsDysregulationoftheHypothalamicPituitaryAdrenal(HPA)AxisTheHPAaxisisaplexsystemthatregulatescortisolproductionInCushing'ssyndrome,thereisoftendysregulationofthisaxis,leadingtooverproductionofcortisolHormoneImbalancesAdrenalHyperplasiaInsomecasesofCushing'ssyndrome,theadultlandsbecameenlarged(hyperplasia)andproduceexcesscortisolThiscanbecausedbyvariousfactors,includingPituitaryGlandTumorsthatsecretexcessaerobichormone(ACTH)AdrenalTumorsTumorsoftheadultlands,knownasadultcardiovascularoradult,canalsocauseCushing'ssyndromebyproducingcortisolindependentlyofACTHregulationAdrenalGlandDysfunctionVSTumorsofthePituitaryland,specificallythosethatsecretexcessACTH,areamoncauseofCushing'ssyndromeThesetutorscanleadtooversimulationoftheadultlandsandsubsequencecortisoloverintroductionPituitaryHyperplasiaRare,thePituitaryGlanditselfmaybeeenlarged(hyperplasia)andsecretexcessACTH,leadingtoCushing'ssyndromePituitaryTumorsPituitaryGlandInvolvementGeneticandEnvironmentalFactorsSomeindividualsmayhaveageneticpredispositiontodevelopingCushing'ssyndrome,specificallyincaseswherethereisafamilyhistoryoftheconditionorrelatedendocrinedisordersGeneticpredispositionWhiletheactualroleofenvironmentalfactorsinthedevelopmentofCushing'ssyndromeisnotfullyunderstood,containsexposures,suchaslongtermstressorcentralmedicine,maycontributetotheconditioninsustainableindividualsEnvironmentalFactors04ClinicalManifestationsofCushing'sSyndromePatientswithCushing'ssyndromeofdevelopingcentralobjectivity,characterizedbyincreasedfatpositionaroundtheabdomenandwaitIncreasedabsolutefatpositionInadditiontocentralobjectivity,patientsmayhavealsoexperiencedoverallweightgainduetoexcessglucoseproductionWeightgainCentralObesityandWeightGainExcessglossicoidscanleadtomusclewastingandweakness,specificallyintheshoulders,hips,andthighsMuscleweaknessCushing'ssyndromecanalsobecausedbyOsteoporosis,aconditioncharacterizedbydecreasedbonedensityandincreasedriskofframesOsteoporosisJointandmultiplepaintaremonplaintsinpatientswithCushing'ssyndromeArthralgiaandmyalgiaMusculoskeletalChangesThinandfragileskinTheskinofpatientswithCushing'ssyndromemaybeethin,fragile,andeasilybrokenStretchmarksStretchmarks,alsoknownasstripe,areamonfindinginCushing'ssyndromeandarecausedbytheskin'sinabilitytokeepupwithrapidgrowthorexpansionAcneandhirsutismExcessglossicoidscanalsoleadtoAcneandhirsutism(excesshairgrowth)inaffectedindividualsDermatologicalManifestationsNeuropsychiatricSymptomsInsomnia,hypersomnia,andothersleepdisturbancesaremoninpatientswiththisconditionSleepdisturbancesPatientswithCushing'ssyndromemayexperiencedepression,anxiety,andothermooddisordersduetotheeffectsofexcessglucoseonthebrainDepressionandanxietyCognitivefunctionssuchasmemory,concentration,andexecutivefunctionsmaybepaidinpatientswithCushing'ssyndromeCognitiveimplementation05DiagnosticEvaluationforCushing'sSyndromeThinningoftheskinwitheasybruisingandwidepurplestripe(stripemarks)ProximalmuscleweaknessSignsofdiamondsmellotusorglucoseintegrityHypertensionCentralobjectivitywitharounded,moonshapedface(knownas"moonfacts")PhysicalExaminationFindings24hoururinaryfreecortisolexceptionElevatedlevelssuggestexcesscortisolproductionLatenightsalivarycortisolmeasurementAconservativeandnonvolatilemethodtodetectelevatedcortisollevelsDexamethasonepressiontestAdministrationofdexamethasone,asyntheticglucocorticoid,followedbymeasurementofcortisollevelstoassesstheabilityoftheadultlandstosuppresscortisolproductionLaboratoryTestingProceduresAbsoluteputedtomography(CT)scanormagneticresonanceimaging(MRI)TovisualizetheadultlandsanddetectanyabnormalitiessuchasadultadenomaorhyperplasiaPituitaryMRIToevaluatethepituitarylandanddetectanytubersorotherabnormalitiesthatmaybecausingACTHdependentCushing'ssyndromeInferiorpetroleumSinussampling(IPSS)AspecializedprocedureusedtomeasureACTHlevelsdirectlyfromthepulmonaryglandanddeterminethesourceofACTHdependentCushing'ssyndromeImagingStudiesandTechnologiesAconditionthatmimicsthesignsandsymptomsofCushing'ssyndromebutisnotcausedbyexcesscortisolproductionItistypicallyassociatedwithalcoholism,objectivity,depression,andothermedicalconditionsArayformofCushing'ssyndromecharacterizedbyperiodicepisodesofcortisolexcessinterspersedwithnormalcorti