BMJ Best Practice
最后审核时间： 一月 2019
最近更新时间： 十月 2018

小结

定义

病史和查体

关键诊断因素

  • 存在的危险因素
  • 面部充血
  • 锁骨上脂肪垫
  • 紫纹
全部具体信息

其他诊断因素

  • 女性
  • 高血压
  • 糖耐量异常和糖尿病
  • 过早的骨质疏松和原因不明的骨折
全部具体信息

危险因素

  • 外源性皮质类固醇的使用
  • 垂体腺瘤
  • 肾上腺腺瘤
  • 肾上腺癌
全部具体信息

诊断性检查

首要检查

  • 尿妊娠试验
  • 血清葡萄糖
  • 深夜唾液皮质醇
  • 1 mg 过夜地塞米松抑制试验
全部具体信息

需要考虑的检查

  • 血浆硫酸脱氢表雄酮（DHEAS）水平
  • 清晨血浆促肾上腺皮质激素 (ACTH) 水平
  • 大剂量地塞米松抑制试验
  • 垂体 MRI 检查
全部具体信息

治疗流程

疾病持续状态

库欣病（分泌促肾上腺皮质激素 [ACTH] 的垂体瘤）

异位 ACTH 或 CRH 综合征

单侧肾上腺癌或腺瘤导致的 ACTH 非依赖性库欣综合征

双侧肾上腺疾病（增生或腺瘤）导致的 ACTH 非依赖性库欣综合征

贡献者

作者 查看所有

Professor of Medicine (Endocrinology) and Neurological Surgery

Director

Pituitary Center

Oregon Health & Science University

Portland

OR

利益冲突披露
MF is an author of several references cited in this monograph. She is a scientific consultant and principal investigator (with a grant to the university) for Novartis and Strongbridge. She is an unpaid medical advisor for the Cushing's Support and Research Foundation; she is also chair of the Endocrine Society Guidelines Committee, chair of the Pituitary Society Physician Education Committee, and member of the Board of Directors of the Pituitary Society.

Dr Maria Fleseriu would like to gratefully acknowledge Dr Ty Carroll and Dr James Finding, previous contributors to this monograph. TC is an author of a number of references cited in this monograph. He is an investigator in clinical trials sponsored by Corcept. JF is an author of a number of references cited in this monograph. He is a consultant for, and investigator in, clinical trials sponsored by Corcept and Novartis.

同行评议专家 查看所有

Professor of Medicine

Director of Research

College of Medical and Dental Sciences

University of Birmingham

Honorary Consultant Physician

Queen Elizabeth Hospital

Birmingham

UK

利益冲突披露
PMS declares that he has no competing interests.

Head

Department of Endocrinology

University Hospital of Bordeaux

Pessac

France

利益冲突披露
AT declares that he has no competing interests.

Chief

Endocrine Research Department

Instituto de Investigaciones Médicas A. Lanari

University of Buenos Aires and IDIM-CONICET

Buenos Aires

Argentina

利益冲突披露
LC declares that she has no competing interests.

Professor of Medicine

Director

Division of Endocrinology, Diabetes & Metabolism

University of Texas Medical School

Houston

TX

利益冲突披露
PRO declares that he has no competing interests.

Assistant Professor

Department of Endocrine Neoplasia and Hormonal Disorders

Division of Internal Medicine

University of Texas MD Anderson Cancer Center

Houston

TX

利益冲突披露
MAH declares that he has no competing interests.

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