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目的探讨各项生化与影像学检查对Ｃｕｓｈｉｎｇ综合征的诊断价值。方法对经手术和病理证实的３２例Ｃｕｓｈｉｎｇ综合征（Ｃｕｓｈｉｎｇ病所致的肾上腺皮质增生２２例，肾上腺腺瘤８例，肾上腺癌１例，异源性ＡＣＴＨ综合征１例）进行回顾性分析。结果①血皮质醇（Ｆ）单次升高者占８４．４％，昼夜节律失常率为１００％；②２４ｈ尿１７－羟皮质类固醇（１７－ＯＨ）：增生组９０．９％升高，腺瘤组８７．５％升高；③２４ｈ尿游离皮质醇（ＵＦＣ）：测定的８例患者（增生者６例，腺瘤者２例）ＵＦＣ均明显升高（１００％）；④血浆ＡＣＴＨ：测定的８例中，增生者５例升高（５／８，６２．５％），而腺瘤者２例均在正常水平以下，１例异源性ＡＣＴＨ综合征升高；⑤小剂量地塞米松抑制试验（ＤＳＴ）：增生组阳性率均为９５．５％，腺瘤组１００％；⑥大剂量ＤＳＴ：增生组阳性率分别为８１．８％和７２．７％；而腺瘤组均不被抑制（抑制率均＜５０％）；⑦Ｂ超：增生组６８．２％、腺瘤组８７．５％有阳性发现；⑧肾上腺ＣＴ：增生组９０．９％、腺瘤组１００％有阳性发现；颅脑ＣＴ：增生组中的２０例行ＣＴ检查，仅２例（１０％）垂体有阳性发现。结论血Ｆ昼夜节律失常、ＵＦＣ测定与小剂量ＤＳ?
Objective To investigate the diagnostic value of various biochemical and imaging examinations on Cushing’s syndrome. Methods 32 cases of Cushing’s syndrome confirmed by operation and pathology (22 cases of adrenal hyperplasia due to Cushing disease, 8 cases of adrenal adenoma, 1 case of adrenal carcinoma and 1 case of heterogenous ACTH syndrome) were retrospectively analyzed. Results (1) Cortisol (F) single increased 84.4%, circadian rhythm dysfunction rate was 100%; ② 24h urinary 17-hydroxy corticosteroids (17-OH): hyperplasia group 90.9% (87.5%) in the tumor group; (3) UFC in 24h urine: The UFC in 8 patients (6 cases of hyperplasia and 2 cases of adenoma) were significantly increased (100%); ④ The plasma ACTH: Of the 8 cases, 5 cases of hyperplasia increased (5/8, 62.5%), and 2 cases of adenoma were below normal levels, 1 case of heterologous ACTH syndrome increased; ⑤ small doses of dexamethasone The inhibition rate of DST was 95.5% in the hyperplasia group and 100% in the adenoma group. The positive rates of high dose DST and hyperplasia group were 81.8% and 72.7% ⑦B ultrasound: 68.2% in hyperplasia group, 87.5% in adenoma group were positive; ⑧Adrenal CT: 90.9% in hyperplasia group, 100% in adenoma group, Found positive; brain CT: 20 patients in the group hyperplasia CT, only 2 cases (10%) had positive findings pituitary. Conclusion Circadian rhythm of blood F, UFC and low dose DS?