尿游离皮质醇和小剂量地塞米松抑制试验是Cushing综合征的第一线筛选试验,午夜唾液皮质醇因敏感性和特异性高,方法简单,越来越受重视。血清ACTH水平、大剂量地塞米松抑制试验、CRH兴奋试验和影像学检查仍是鉴别Cushing病与异位ACTH综合征的主要方法,必要时可行双侧岩下窦静脉取样(BIPSS)检测。经蝶窦手术是Cushing病第一线治疗方法,但长期随访显示其复发率仍较高。Cushing综合征并发症的治疗也十分重要。 Urinary free cortisol and low-dose dexamethasone inhibition test is the first-line screening test for Cushing syndrome. Midnight salivary cortisol is more and more sensitive and specific due to its high sensitivity and specificity. Serum ACTH levels, high-dose dexamethasone suppression test, CRH excitability test and imaging studies are still the main method to identify Cushing’s disease and ectopic ACTH syndrome. If necessary, bilateral inferior petrosal sinus venous sampling (BIPSS) can be performed. Transnasal surgery is the first line of treatment of Cushing disease, but the long-term follow-up showed that the recurrence rate is still high. The treatment of Cushing syndrome complications is also very important.