131例库欣综合征患者的临床特征分析

Clinical features of 131 patients with Cushing syndrome

131例（男性33例，女性98例）库欣综合征患者中，库欣病53例，肾上腺腺瘤49例，大结节增生12例，异位ACTH综合征16例，肾上腺皮质腺癌l例。不同类型的库欣综合征患者在发病年龄、病程、8：00和0：00血皮质醇水平、24h尿游离皮质醇水平、空腹血糖、HbA1c、大剂量和小剂量地塞米松抑制后8：00皮质醇水平等指标有统计学差异（均P〈0．05）。16例异位ACTH综合征患者来源于肺部5例，胰腺3例，胸腺2例，肝脏2例；来源不明4例。131例库欣综合征患者中，合并糖尿病60例，糖耐量受损22例，血糖正常49例。库欣综合征患者女性发病高于男性；不同类型的库欣综合征患者，主要临床表现及生化指标具有差异；糖代谢异常是库欣综合患者的常见临床表现。

One hundred and thirty-one patients with Cushing syndrome （ 33 males and 98 females ） were enrolled, including 53 cases of Cushing＇s disease, 49 cases of adrenal adenoma, 12 cases of big nodular hyperplasia, 16 cases with ectopic ACTH syndrome, and 1 case with adrenal cortical carcinoma. The age of onset, duration, 8 ： 00 and 0 ： O0 plasma cortisol levels, 24 h urinary free cortisol levels, fasting plasma glucose, HbAjc, 8 ： O0 cortisol level after high- and low-dose dexamethasone suppression test were significantly different among different types of Cushing syndrome（ all P〈O. 05 ）. The primary lesion in 16 cases of ectopic ACTH syndrome were found in lung（ n = 5 ） , pancreas（ n = 3 ） , thymus（ n = 2 ） , liver （ n = 2 ） , and unknown origin （ n = 4 ）. There were 60 cases combined with diabetes（45. 8% ）, 22 cases with impaired glucose tolerance （ 16.8% ）, and 49 cases with no^naglycemia （37.4%） in these 131 patients. The probability of Cushing syndrome in female was higher than that in man. There were significantly different for the clinical manifestations and biochemical parameters among different types of Cushing syndrome. Abnormal glucose metabolism is the common clinical manifestations of patients with Cushing syndrome.