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Abstract：
The clinical characteristics of Cushing\'s syndrome (CS) vary with etiology, and few studies have investigated the risk factors affecting CS recurrence after surgery. This retrospective study involved 202 patients diagnosed with CS between December 2012 and December 2022. The patients were divided into three groups according to etiology: Cushing\'s disease (CD), adrenocortical adenoma (ACA), and ectopic adrenocorticotropic hormone (ACTH) syndrome (EAS). Of the patients with CS, 41.9% had hypokalemia and 15.0% had hypophosphatemia. The cortisol levels were negatively correlated with blood potassium, blood chlorine, and blood phosphorus. Moreover, 22.4% of patients had an abnormal heart structure, 11.2% had centripetal remodeling, 5.6% had centripetal hypertrophy, and 5.6% had centrifugal hypertrophy. The overall recurrence rate of CS caused by pituitary tumors and adrenal adenoma was 25.7%. The recurrence times were longer in the ACA group versus the CD group, in patients < 50 years of age versus in patients ≥ 50 years old group, and in patients with CD with tumors ≥ 1 cm versus tumors < 1 cm. Age, preoperative cortisol level, postoperative cortisol level, and absolute neutrophil value were closely related to postoperative recurrence, and etiology was an independent predictor of tumor recurrence in patients with CS. The results of this study showed that CS caused by different etiologies showed different clinical manifestations, blood electrolyte characteristics, and that CS could affect patient cardiac structure and function. Etiology is an independent predictor of tumor recurrence in patients with CS.
摘要：
库欣综合征(CS)的临床特点因病因而异,很少有研究调查影响CS术后复发的危险因素。这项回顾性研究涉及2012年12月至2022年12月期间诊断为CS的202例患者。根据病因将患者分为三组：库欣病（CD），肾上腺皮质腺瘤(ACA),和异位促肾上腺皮质激素（ACTH）综合征（EAS）。在CS患者中，41.9%有低钾血症，15.0%有低磷血症。皮质醇水平与血钾呈负相关,血氯,和血磷。此外，22.4%的患者心脏结构异常，11.2%有向心重塑，5.6%有向心肥大,5.6%有离心肥大。由垂体瘤和肾上腺腺瘤引起的CS的总复发率为25.7%。与CD组相比，ACA组的复发时间更长，<50岁的患者与≥50岁的患者组相比，以及肿瘤≥1cm与肿瘤<1cm的CD患者。年龄,术前皮质醇水平,术后皮质醇水平,中性粒细胞绝对值与术后复发密切相关,病因是CS患者肿瘤复发的独立预测因子。这项研究的结果表明，由不同病因引起的CS表现出不同的临床表现，血液电解质特性，CS可能会影响患者的心脏结构和功能。病因是CS患者肿瘤复发的独立预测因子。
