库欣综合征的诊断方法研究进展
Research Progress in Diagnostic Methods of Cushing’s Syndrome
DOI: 10.12677/acm.2026.1662449, PDF,   
作者: 郭林佳, 闫 飞*：山东大学齐鲁医院内分泌与代谢病科，山东 济南
关键词: 库欣综合征；皮质醇；功能诊断试验；影像诊断；Cushing’s Syndrome； Cortisol； Dynamic Function Tests； Diagnostic Imaging
摘要: 库欣综合征是下丘脑–垂体–肾上腺轴调控异常引发的慢性皮质醇增多的一类疾病，是内分泌科公认的疑难疾病。其诊断受皮质醇分泌波动、患者个体差异及检测技术等因素干扰，漏诊误诊率较高。本文系统梳理近年库欣综合征诊断领域的研究进展，重点评价了定性诊断中24小时尿游离皮质醇、深夜唾液皮质醇、小剂量地塞米松抑制试验、毛发皮质醇检测的适用人群与局限性；分析了定位诊断中影像学检查、功能试验及双侧岩下窦采血的诊断效能与应用场景；同时介绍了新型诊断技术的研究成果。本文旨在为临床规范化应用库欣综合征生化检测提供理论依据与实操指导。
Abstract: Cushing’s syndrome (CS), characterized by chronic glucocorticoid excess due to dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis, remains one of the most formidable diagnostic challenges in clinical endocrinology. Diagnostic precision is often compromised by episodic cortisol secretion, inter-individual variability, and technical disparities in laboratory assays, leading to significant rates of misdiagnosis. This review synthesizes recent advancements in CS diagnostics, specifically evaluating the clinical utility and limitations of 24-hour urinary free cortisol (UFC), late-night salivary cortisol (LNSC), low-dose dexamethasone suppression test (LDST), and hair cortisol analysis for qualitative screening. Furthermore, the diagnostic efficacy of imaging modalities, functional assays, and bilateral inferior petrosal sinus sampling (BIPSS) for etiological localization is analyzed. Emerging diagnostic technologies are also discussed. This paper aims to provide a standardized framework and practical evidence for the biochemical evaluation of Cushing’s syndrome in clinical practice.
文章引用：郭林佳, 闫飞. 库欣综合征的诊断方法研究进展[J]. 临床医学进展, 2026, 16(6): 2275-2285. https://doi.org/10.12677/acm.2026.1662449

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