A study of the mechanism of the steroid withdrawal syndrome. Evidence for integrity of the hypothalamic-pituitary-adrenal system.
A study of the mechanism of the steroid withdrawal syndrome. Evidence for integrity of the hypothalamic-pituitary-adrenal system.
复制标题
类固醇戒断综合征机制的研究。
DOI：
10.1210/jcem-20-3-339
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发表时间：
1960
期刊：
影响因子：
--
通讯作者：
P. Bondy
中科院分区：
文献类型：
--
作者：
T. Amatruda;D. Hollingsworth;N. D’Esopo;G. V. Upton;P. Bondy
10例男性肺结核患者在接受强的松30 mg治疗后发生库欣综合征。每日一次，促肾上腺皮质激素（ACTH），40单位，每隔一天，约6个月，除了抗结核化疗。肾上腺皮质对静脉注射ACTH的反应性在泼尼松-ACTH治疗期间之前、期间和之后进行测试。虽然治疗开始前血浆皮质醇的基线水平高于正常对照组，但对ACTH的反应发生了较小的上升，导致最终水平相似。治疗期间，基线血浆皮质醇水平和对ACTH的反应与正常对照组相比均降低。尽管经过5 ~ 6个月的治疗，泼尼松和ACTH的剂量逐渐减少，但仍出现了明显的症状，使人想起阿狄森病或库欣综合征双侧肾上腺切除术后出现的症状;这些症状对泼尼松治疗的重新开始有反应。
ABSTRACT Cushing's syndrome developed in 10 male patients with pulmonary tuberculosis who were receiving prednisone, 30 mg. daily, and zinc-corticotropin (ACTH), 40 units every other day, for about six months in addition to anti-tuberculosis chemotherapy. The responsiveness of the adrenal cortex to intravenous ACTH was tested before, during and after the period of prednisone-ACTH therapy. Although the baseline level of plasma cortisol before initiation of therapy was higher than that of normal controls, a smaller rise occurred in response to ACTH, resulting in similar final levels. During treatment both the baseline plasma cortisol level and the response to ACTH were reduced compared to normal controls. Despite very gradual tapering of the dosages of prednisone and ACTH after five to six months of therapy, striking symptoms developed, reminiscent of those occurring in Addison's disease or after bilateral adrenalectomy for Cushing's syndrome; these symptoms responded to reinstitution of prednisone therapy....