柯兴氏综合征的原因相当复杂,可以是脑垂体、肾上腺病变、肺癌、胰腺癌、鼻咽癌等也均可致血皮质醇增高症,尚有一部分病因不明,甚至血放射免疫学检查提示来源脑垂体,但手术未发现异常.柯兴氏病是本综合征的主要原因,约占59.3～70%,但有时诊断困难.现结合病例复习文献探讨其诊断和治疗.1 临床资料例1:女,19岁,未婚,向心性肥胖1年,闭经半年.l年来先面部、后背部发胖,体重增加6kg,体毛增多,乏力,脱发,腰背酸痛,视物模糊,燥热,尿量增多,一昼夜饮水2000～3000ml,劳累时双下肢水肿.4个月来心慌,头晕,视物模糊加重,血压21.3/16.okPa,皮肤变黑、粗糙,乳房渐小,面红,有红色斑块样痤疮.在外院两次肾上腺CT扫描提示有增生,蝶鞍平片未见异常,垂体CT扫描未见异常.满月脸,多血质外貌,肩背脂肪增厚,前额、肩背有痤疮.颈背多毛,阴毛呈男性分布.双股内侧 The reason for Cushing’s syndrome is quite complex, which can be pituitary, adrenal lesions, lung cancer, pancreatic cancer, nasopharyngeal cancer, etc. can also lead to hypercortisolism, there are still some unknown etiology, or even blood radioimmunoassay prompted The source of the pituitary gland, but the operation was not found abnormal Cushing’s disease is the main cause of the syndrome, accounting for about 59.3 to 70%, but sometimes difficult to diagnose .Combining with case review literature to explore its diagnosis and treatment .1 clinical data example 1 : Female, 19 years old, unmarried, concentric obesity for 1 year, amenorrhea for half a year .l year first facial, back fat, weight gain 6kg, body hair increased, fatigue, hair loss, back pain, blurred vision, hot flashes, increased urine output , A day and night drinking 2000 ~ 3000ml, exertion of both lower extremity edema .4 months palpitation, dizziness, blurred vision, blood pressure 21.3 / 16.okPa, the skin becomes dark, rough, breasts are small, reddish, red patches Acne in the hospital two adrenal CT scan prompted hyperplasia, sella flat film showed no abnormalities, pituitary CT scan showed no abnormalities. Full moon face, more blood quality appearance, shoulder fat thickening, forehead, shoulder acne. Hirsch hairy, pubic hair was male distribution