摘要目的 总结双侧肾上腺病变的病因构成,分析疾病谱变化趋势.方法 回顾性分析.收集1994至2017年在北京大学第三医院住院诊治的所有双侧肾上腺病变患者的病历资料,分析双侧肾上腺病变的病因构成和疾病谱变化.结果 共收集双侧肾上腺病变患者260例,其中男146例(56.2％),女114例(43.8％),就诊年龄(55.4±16.2)岁.双侧肾上腺增生75例(28.8％)、双侧肾上腺腺瘤71例(27.3％)、双侧肾上腺转移癌51例(19.6％)、双侧肾上腺病变病因不同27例(10.4％)、双侧肾上腺嗜铬细胞瘤13例(5.0％).有明确内分泌功能评估资料的双侧肾上腺病变患者184例,其中无功能性肾上腺病变111例(60.3％),原发性醛固酮增多症34例(18.5％)、嗜铬细胞瘤15例(8.1％)、先天性肾上腺皮质增生症13例(7.1％)、原发性肾上腺皮质功能减退症6例(3.3％)、库欣综合征5例(2.7％).以8年为一时间段,3个时间段双侧肾上腺病变例数逐年增多,分别为8、41、211例.结论 住院患者中双侧肾上腺病变以肾上腺增生最常见,且无功能性病变比例最高.功能性双侧病变中以原发性醛固酮增多症和嗜铬细胞瘤多见.

abstractsObjective To summarize the etiologies of bilateral adrenal lesions and the changes of the disease profile in hospitalized patients.Methods Bilateral adrenal lesion screening was conducted in all patients admitted to Peking University Third Hospital from 1994 to 2017.The etiologies and disease profiles of bilateral adrenal lesions were retrospectively analyzed.Results A total of 260 patients with bilateral adrenal lesions were included in the study.There were 146 males and 114 females with a mean age of (55.4± 16.2) years.The most common adrenal lesion was bilateral adrenal hyperplasia (75 cases,28.8％),followed by bilateral adrenal adenomas (71 cases,27.3％),metastatic carcinoma (51 cases,19.6％),discordant bilateral adrenal lesions (27 cases,10.4％),bilateral pheochromocytomas (13 cases,5.0％),and others.The clear data of endocrine function evaluation could be found in 184 patients.Among them,111 cases (60.3％) were nonfunctioning lessions,34 cases (18.5％) with primary aldosteronism,15 cases (8.1％) with pheochromocytoma,13 cases (7.1％) with congenital adrenal hyperplasia,6 cases (3.3％) with primary hypoadrenocorticism,and 5 cases (2.7％) with Cushing syndrome.Using every 8 years as a period of time,the number of hospitalized patients with bilateral adrenal lesions increased with years in three periods (8,41 and 211 cases,respectively).Conclusions The most common cause of bilateral adrenal lesions is adrenal hyperplasia in the hospitalized patients.More than half of bilateral adrenal lesions are nonfunctioning.In functional bilateral lesions,primary aldosteronism and pheochromocytoma account for a large proportion.