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绝大多数异位促肾上腺皮质激素(ACTH)综合征是由恶性肿瘤引起的,其中约一半为小细胞性肺癌。临床上表现为血浆ACTH水平显著升高,常伴有过度的色素沉着。代谢方面的表现为高血压、水肿、低血钾、衰弱及糖耐量异常等。上述症状常突然出现并呈进行性加重,但有时缺乏典型的柯兴氏综合征的体征。据报道,异位ACTH综合征的发病率可能居皮质醇增多症发病率中的第3位,约为15％,但临床上常常漏诊。现报道两例由我院收治的恶性肿瘤合并异位ACTH综合征的病例。
The vast majority of ectopic adrenocorticotropic hormone (ACTH) syndromes are caused by malignant tumors, of which approximately half are small cell lung cancers. Clinically, there is a significant increase in plasma ACTH levels, often accompanied by excessive pigmentation. Metabolic manifestations are hypertension, edema, hypokalemia, weakness, and impaired glucose tolerance. The above symptoms often appear suddenly and appear progressively worse, but sometimes there is a lack of typical signs of Cushing’s syndrome. According to reports, the incidence of ectopic ACTH syndrome may rank 3rd in the incidence of cortisol hyperplasia, which is about 15%, but clinically it is often missed. Two cases of malignant tumor accompanied by ectopic ACTH syndrome treated by our hospital are reported.