关键词: 库欣综合征, 促肾上腺皮质激素, 生长抑素

Abstract:

Abstract：Cushings syndrome is a heterogeneous complex endocrine disease with overproduction of endogenous cortisol.The operation is the first choice for Cushings syndrome.However，it is possible that the cause is difficult to identify and the disease is persistent after surgery in some patients.It has potential serious complications if untreated or inadequately treated.Medical treatment can temporarily suppress excessive cortisol production and ameliorate its clinical manifestations while ultimate therapy becomes effective.We describe pharmacological approaches to the treatment of Cushings syndrome.For the drugs that suppress the secretion of adrenocorticotropic hormone，somatostatin analogs such as pasireotide has been proved effective in clinical trials.Dopamine receptor agonist such as cabergoline has also been tested to prove the potential therapeutic benefit.For the drugs that suppress cortisol secretion，ketoconazole，fluconazole，aminoglutethimide，metyrapone，mitotane and etomidate are playing a potential role either alone or in combination.A third category of drugs is glucocorticoid receptor antagonists.Mifepristone has been approved for the patients with persistent or recurrent Cushings syndrome who was not amenable to surgery.The review provides a complete survey of the current drugs used and new advances in the medical treatment of Cushings syndrome.In Conclusion，the most appropriate medical management should be given for the patient depending on the different situations.

Key words: Cushings syndrome, ACTH, somatostain