本文引用：譚惠文, 唐宇, 餘葉蓉, 李建薇, 李佳琦, 王偉, 蔡博文, 姜曙. 國際垂體協會《庫欣病的診斷和管理共識（更新版）》解讀——診斷篇[J]. 中國全科醫學, DOI: 10.12114/j.issn.1007-9572.2022.0190.

　　Huiwen Tan, Yu Tang, Yerong Yu, Jianwei Li , Jiaqi Li , Wei Wang, Bowen Cai, Shu Jiang. Interpretation ofthe Pituitary Society Consensus on Diagnosis and Management of Cushing Disease[J]. Chinese General Practice, DOI: 10.12114/j.issn.1007-9572.2022.0190.

　　摘要： 庫欣病是以高皮質醇血症為特征的内源性庫欣綜合征最常見的病因，是由分泌促腎上腺皮質激素（ACTH）的垂體腺瘤引起的臨床綜合征。庫欣病過度分泌的ACTH刺激雙側腎上腺皮質增生并引起高皮質醇血症，可導緻電解質紊亂，糖、脂代謝紊亂等一系列嚴重的臨床症候群，累及全身多個髒器及系統。庫欣病臨床症狀複雜多樣，其診斷和治療極具挑戰性。國際垂體協會在2021年12月發布了《庫欣病的診斷和管理共識（更新版）》，該指南更新關注庫欣病的并發症和合并症，諸如高凝狀态、心血管疾病、骨代謝疾病、生長激素缺乏及感染等；讨論了最新證據在臨床實踐中的應用，尤其側重于新的治療選擇、篩查、診斷算法以及防治疾病複發的最佳實踐。本文立足于最新的循證醫學證據，對《庫欣病的診斷和管理共識（更新版）》讨論的庫欣病相關的實驗室檢查、影像學檢查、診斷和治療管理流程及複發監測等多方面進行重點解讀，以期提高廣大全科及專科醫師對庫欣病的理解，更好地指導規範化的診療，改善庫欣病患者預後。

　　關鍵詞: 庫欣綜合征, 庫欣病, 診療指南, 垂體腺瘤, 診斷技術和方法, 治療

　　Abstract: Cushing disease，the most common cause of endogenous Cushings syndrome characterized by hypercortisolemia，is a clinical syndrome caused by adrenocorticotropic hormone（ACTH）——secreting pituitary adenomas. The excessive secretion of ACTH in Cushings disease stimulates bilateral adrenal hyperplasia and causes hypercortisolemia，which can lead to a series of severe clinical syndromes such as electrolyte imbalance，glucose and lipid metabolism disorders，involving multiple organs and systems in the body. The clinical symptoms of Cushings disease are complex and diverse，and its diagnosis and treatment are extremely challenging. In December 2021，the International Pituitary Society released the Consensus on Diagnosis and Management of Cushings Disease：a Guideline Update，which focuses on the complications and comorbidities of Cushings disease，such as hypercoagulability，cardiovascular disease，metabolic bone disease，growth hormone deficiency and infection，etc.；discusses the application of the latest evidence in clinical practice，with a particular focus on new treatment and screening options，diagnostic algorithms，and best practices for preventing disease recurrence. Based on the latest evidence-based medical evidence，this article focuses on the interpretation of Cushings disease——related laboratory examinations，imaging examinations，diagnosis and treatment management procedures，and recurrence monitoring discussed in the Consensus on Diagnosis and Management of Cushings Disease：a Guideline Update，in order to improve the general practitioners and specialists’understanding of this syndrome and improve the prognosis of patients with Cushings disease.

　　Key words: Cushing syndrome, Cushing disease, Diagnostic and treatment guideline, Pituitary adenoma, Diagnostic techniques and procedures, Therapy

　　國際垂體協會《庫欣病的診斷和管理共識（更新版）》解讀——診斷篇

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