诊断库欣综合征的敏感性和特异性:高质量的证据显示,唾液皮质醇的敏感性为 92%-100%,特异性为 93%-100%。[59]Carroll T, Raff H, Findling JW. Late-night salivary cortisol measurement in the diagnosis of Cushing's syndrome. Nat Clin Pract Endocrinol Metab. 2008 Jun;4(6):344-50.http://www.ncbi.nlm.nih.gov/pubmed/18446140?tool=bestpractice.com[60]Elamin MB, Murad MH, Mullan R, et al. Accuracy of diagnostic tests for Cushing's syndrome: a systematic review and metaanalyses. J Clin Endocrinol Metab. 2008 May;93(5):1553-62.http://jcem.endojournals.org/content/93/5/1553.fullhttp://www.ncbi.nlm.nih.gov/pubmed/18334594?tool=bestpractice.com
系统评价或者受试者>200名的随机对照临床试验(RCT)。
诊断库欣综合征的敏感性和特异性:高质量的证据显示,唾液皮质醇的敏感性为 92%-100%,特异性为 93%-100%。[59]Carroll T, Raff H, Findling JW. Late-night salivary cortisol measurement in the diagnosis of Cushing's syndrome. Nat Clin Pract Endocrinol Metab. 2008 Jun;4(6):344-50.http://www.ncbi.nlm.nih.gov/pubmed/18446140?tool=bestpractice.com[60]Elamin MB, Murad MH, Mullan R, et al. Accuracy of diagnostic tests for Cushing's syndrome: a systematic review and metaanalyses. J Clin Endocrinol Metab. 2008 May;93(5):1553-62.http://jcem.endojournals.org/content/93/5/1553.fullhttp://www.ncbi.nlm.nih.gov/pubmed/18334594?tool=bestpractice.com
死亡率下降:中等质量证据显示,缓解库欣综合征患者的皮质醇增多症可降低死亡率,达到与一般人群接近的水平。[63]Swearingen B, Biller BM, Barker FG 2nd, et al. Long-term mortality after transsphenoidal surgery for Cushing disease. Ann Intern Med. 1999 May 18;130(10):821-4.http://www.ncbi.nlm.nih.gov/pubmed/10366371?tool=bestpractice.com
系统评价或者受试者>200名的随机对照临床试验(RCT)。
死亡率下降:中等质量证据显示,缓解库欣综合征患者的皮质醇增多症可降低死亡率,达到与一般人群接近的水平。[63]Swearingen B, Biller BM, Barker FG 2nd, et al. Long-term mortality after transsphenoidal surgery for Cushing disease. Ann Intern Med. 1999 May 18;130(10):821-4.http://www.ncbi.nlm.nih.gov/pubmed/10366371?tool=bestpractice.com
皮质醇增多症的存在情况:来自群体研究的低质量证据显示,6%-9% 偶然发现的肾上腺腺瘤患者患有皮质醇增多症。[23]Reincke M, Nieke J, Krestin GP, et al. Preclinical Cushing's syndrome in adrenal "incidentalomas": comparison with adrenal Cushing's syndrome. J Clin Endocrinol Metab. 1992 Sep;75(3):826-32.http://www.ncbi.nlm.nih.gov/pubmed/1517373?tool=bestpractice.com[24]Terzolo M, Pia A, Ali A, et al. Adrenal incidentaloma: a new cause of the metabolic syndrome? J Clin Endocrinol Metab. 2002 Mar;87(3):998-1003.http://jcem.endojournals.org/content/87/3/998.fullhttp://www.ncbi.nlm.nih.gov/pubmed/11889151?tool=bestpractice.com
系统评价或者受试者>200名的随机对照临床试验(RCT)。
皮质醇增多症的存在情况:来自群体研究的低质量证据显示,6%-9% 偶然发现的肾上腺腺瘤患者患有皮质醇增多症。[23]Reincke M, Nieke J, Krestin GP, et al. Preclinical Cushing's syndrome in adrenal "incidentalomas": comparison with adrenal Cushing's syndrome. J Clin Endocrinol Metab. 1992 Sep;75(3):826-32.http://www.ncbi.nlm.nih.gov/pubmed/1517373?tool=bestpractice.com[24]Terzolo M, Pia A, Ali A, et al. Adrenal incidentaloma: a new cause of the metabolic syndrome? J Clin Endocrinol Metab. 2002 Mar;87(3):998-1003.http://jcem.endojournals.org/content/87/3/998.fullhttp://www.ncbi.nlm.nih.gov/pubmed/11889151?tool=bestpractice.com