国际妇产科学杂志 ›› 2025, Vol. 52 ›› Issue (5): 585-588.doi: 10.12280/gjfckx.20250354

• 产科生理及产科疾病: 病例报告 • 上一篇    下一篇

妊娠期库欣综合征一例

钟雅雯, 李瑞满()   

  1. 510630 广州,暨南大学附属第一医院妇产科
  • 收稿日期:2025-04-07 出版日期:2025-10-15 发布日期:2025-10-16
  • 通讯作者: 李瑞满 E-mail:hqyyck@126.com

A Case of Cushing Syndrome during Pregnancy

ZHONG Ya-wen, LI Rui-man()   

  1. Department of Obstetrics and Gynecology, The First Affiliated Hospital of Jinan University, Guangzhou 510630, China
  • Received:2025-04-07 Published:2025-10-15 Online:2025-10-16
  • Contact: LI Rui-man E-mail:hqyyck@126.com

摘要:

库欣综合征(Cushing syndrome,CS)是一种以高皮质醇血症为特征的罕见内分泌疾病,妊娠合并CS更为罕见,受妊娠期皮质醇水平生理性升高的影响,该病诊断与管理尤为复杂。报告1例以髋部疼痛为首发症状的妊娠合并促肾上腺皮质激素(adrenocorticotropic hormone,ACTH)非依赖性CS患者,伴明显代谢紊乱和典型CS体征。实验室检查提示高皮质醇血症,肾上腺超声发现右侧肾上腺腺瘤。多学科团队协作制定个体化方案,患者于孕30+3周行剖宫产,产后6周行右肾上腺切除术,术后症状显著改善,随访显示母婴结局良好。本例提示,妊娠期如出现异常体质量增长、代谢紊乱或皮肤改变,应警惕潜在内分泌疾病的可能并尽早评估;多学科协作与心理干预是优化CS患者妊娠结局的关键。

关键词: 库欣综合征, 妊娠, 诊断, 治疗, 妊娠结局

Abstract:

Cushing syndrome (CS) is a rare endocrine disorder characterized by hypercortisolism. CS complicating pregnancy is even rarer. Affected by the physiological increase of cortisol levels during pregnancy, the diagnosis and management of this disease are particularly complex. A case of a pregnant patient with adrenocorticotropic hormone (ACTH)-independent CS presenting with hip pain as the first symptom is reported. The patient had obvious metabolic disorders and typical signs of CS. Laboratory tests indicated hypercortisolism, and an adrenal ultrasound revealed an adenoma in the right adrenal gland. A multidisciplinary team collaborated to develop an individualized plan. The patient underwent a cesarean section at 30+3 weeks of gestation, and a right adrenalectomy was performed 6 weeks after delivery. The symptoms improved significantly after the operation, and the follow-up indicated favorable outcomes for both the mother and the infant. This case suggests that if there are abnormal weight gain, metabolic disorders, or skin changes during pregnancy, the possibility of potential endocrine diseases should be alerted and evaluated as early as possible. Multidisciplinary collaboration and psychological intervention are the keys to optimizing the pregnancy outcomes of CS patients.

Key words: Cushing syndrome, Pregnancy, Diagnosis, Therapy, Pregnancy outcomes