The plasma cortisol and corticotropin response to hypoglycemia following adrenal steroid and ACTH administration.
The plasma cortisol and corticotropin response to hypoglycemia following adrenal steroid and ACTH administration.
复制标题
肾上腺类固醇和 ACTH 给药后血浆皮质醇和促肾上腺皮质激素对低血糖的反应。
DOI：
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发表时间：
1975
影响因子：
5.8
通讯作者：
E. Espiner
中科院分区：
文献类型：
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作者：
R. Donald;E. Espiner
血浆皮质醇对低血糖的反应被广泛用作下丘脑-垂体-肾上腺功能的测试。本研究的目的是确定该试验是否为皮质类固醇或ACTH治疗所致肾上腺皮质抑制恢复的患者提供了垂体促肾上腺皮质激素（ACTH）释放的可靠指示。研究的16例患者（6例不止一次）接受了超过5 mg的泼尼松或等效药物，每日超过12个月。停药后18 h进行胰岛素耐量试验。然后，在通过给予二十四角化锌恢复肾上腺功能（如尿生氧类固醇排泄大于35 mg/24 h所示）后3 - 4天重复测试。激素治疗组ACTH对低血糖的反应明显受损。然而，除了1例患者的静息ACTH水平持续升高外，低血糖期间血浆皮质醇和ACTH的最大增量之间存在显著相关性（P <0.01）。激素治疗组和12名正常对照受试者对内源性ACTH的敏感性无显著差异。促肾上腺皮质激素给药后，血浆促肾上腺皮质激素和生长激素对低血糖的反应显着降低，但血浆皮质醇的反应没有显着影响。它的结论是，血浆皮质醇低血糖反应提供了一个有用的指示ACTH释放激素治疗的患者，只要他们最近没有收到外源性ACTH。
The plasma cortisol response to hypoglycemia is widely used as a test of hypothalamic-pituitary-adrenal function. It was the aim of this study to determine whether this test gives a reliable indication of pituitary corticotropin (ACTH) release in patients recovering from adrenocortical suppression due to corticosteroid or ACTH therapy. The 16 patients who were studied (6 on more than one occasion) had received in excess of 5 mg predinisone or equivalent daily for over 12 months. The insulin tolerance tests were carried out 18 h after stopping steroid therapy. The tests were then repeated three to four days after adrenal function had been restored (as indicated by urinary oxogenic steroid excretion of greater than 35 mg/24 h) by zinc tetracosactrin administration. The ACTH response to hypoglycemia was significantly impaired in the steroid-treated group. However with the exception of one patient who had persistently elevated resting ACTH levels there was a significant correlation (P less than 0.01) between the maximum increments in plasma cortisol and ACTH during hypoglycemia. No significant difference in sensitivity to endogenous ACTH could be demonstrated between the steroid-treated group and 12 normal control subjects. Following ACTH administration the plasma ACTH and growth hormone responses to hypoglycemia were significantly reduced, but the response in plasma cortisol was not significantly affected. It is concluded that the plasma cortisol response to hypoglycemia gives a useful indication of ACTH release in steroid-treated patients provided that they have not recently received exogenous ACTH.