Современный взгляд на скрининг и диагностику эндогенного гиперкортицизма

Обзор посвящен современным методам диагностики эндогенного гиперкортицизма. Наряду с эпидемиологическими данными и клинической картиной обсуждается выделение групп риска и выбор пациентов для скрининга. Основное внимание уделяется наиболее информативным диагностическим тестам, простым для выполнения и интерпретации (определение кортизола в суточной моче, малая проба с дексаметазоном, кортизол в вечерней слюне), оценке их чувствительности, специфичности и точек разделения. Детально описаны правила проведения и ограничения, свойственные каждому диагностическому тесту. Кроме того, предложен алгоритм проведения двух тестов и более с целью снижения максимальной чувствительности и специфичности результата. Методы скрининга ориентированы на врачей общей практики и смежных специальностей и должны использоваться для установления диагноза (но не определения генеза) эндогенного гиперкортицизма врачом-эндокринологом.

эндогенный гиперкортицизм, диагностика, свободный кортизол в слюне, свободный кортизол в моче, малая проба с дексаметазоном

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