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作者报道两例具有明显症状的柯兴氏综合征。两例均为老年,且患显性糖尿病、严重低血钾,骨质疏松、水肿及肌无力。血浆皮质醇浓度明显增高且失去分泌节律,血浆 ACTH 浓度亦明显增高且不被地塞米松所抑制,甲吡酮试验时尿17-羟下降,提示可能为异位 ACTH 分泌引起之柯兴氏综合征。但多次头颅、胸部 X 线检查未发现肿瘤。糖尿病及低血钾需使用胰岛素及持续大剂最补钾治疗,但一般情况无明显好转。作者使用甲吡酮500～1,000mg 每日3次治疗,
The authors report two cases of Cushing’s syndrome with obvious symptoms. Both cases were elderly, and suffering from overt diabetes, severe hypokalemia, osteoporosis, edema and muscle weakness. Plasma cortisol levels were significantly increased and loss of secretion rhythm, plasma ACTH concentrations were significantly increased and not inhibited by dexamethasone, metyrapone test urinary 17-hydroxy decreased, suggesting that ectopic ACTH secretion may be caused by Cox’s syndrome Levy However, many skull, chest X-ray examination found no tumor. Diabetes and hypokalemia need to use insulin and sustained large doses of potassium therapy, but in general no significant improvement. The authors use metyrapone 500 ~ 1,000mg three times a day treatment,