A modified dexamethasone suppression test for endogenous depression.
A modified dexamethasone suppression test for endogenous depression.
复制标题
改良的地塞米松抑制试验用于内源性抑郁症。
DOI：
10.1016/0165-1781(85)90066-6
复制
发表时间：
1985
影响因子：
11.3
通讯作者：
Lesser,IM
中科院分区：
文献类型：
--
作者：
Poland,RE;Rubin,RT;Lane,LA;Martin,DJ;Rose,DE;Lesser,IM
为了简化地塞米松抑制试验（DST），我们给予了较低剂量的地塞米松（DEX），并将采样时间缩短为早晨单次血样。 DEX（剂量从 0.125 至 1.0 mg，口服）在 2300 小时以双盲随机方式给予正常志愿者，并在第二天早上 0700 小时采集血样。虽然在 0.375 mg、0.5 mg 和 1.0 mg 剂量的 DEX 后出现了显着的皮质醇抑制，但 0.5 mg 剂量是在所有八名受试者中明显抑制皮质醇的最小剂量。然后将该剂量用于测试内源性抑郁患者的中枢神经系统（CNS）-垂体-肾上腺轴的反馈敏感性。 20 名内源性抑郁患者和 20 名正常志愿者接受标准 1.0 mg DST（在 1500 小时测定 DEX 后血清皮质醇）和简化的 0.5 mg DST（在 0700 小时测定 DEX 后血清皮质醇）。 1.0 mg DST 后，4 名患者 (20%) 和 1 名对照者 (5%) 未出现抑制者，0.5 mg DST 后，9 名患者 (45%) 和 1 名对照者 (5%) 未出现抑制者。此外，还使用 0.5 mg DST 对 9 名重度抑郁症患者（非内源性亚型）和 15 名惊恐发作患者进行了研究。这 24 名患者中只有 2 名 (8%) 是非抑制者。结果表明，单样本 0.5 mg DST 比标准 1.0 mg DST 更敏感，并且修改后的测试的特异性似乎与测试的标准形式相当。
In order to simplify the dexamethasone suppression test (DST), we have administered a lower dosage of dexamethasone (DEX) and shortened the sampling time to a single morning blood sample. DEX (in dosage increments from 0.125 to 1.0 mg, p.o.) was administered at 2300h to normal volunteers in a double-blind randomized fashion, and blood samples were taken at 0700h the following morning. While significant cortisol suppression occurred after the 0.375 mg, 0.5 mg, and 1.0 mg doses of DEX, the 0.5 mg dose was the smallest that clearly suppressed cortisol in all eight subjects. This dose then was used to test the feedback sensitivity of the central nervous system (CNS)-pituitary-adrenal axis in endogenously depressed patients. Twenty endogenously depressed patients and 20 normal volunteers were given both the standard 1.0 mg DST, with post-DEX serum cortisol determined at 1500h, and the simplified 0.5 mg DST, with post-DEX serum cortisol determined at 0700h. Four patients (20%) and one control (5%) were nonsuppressors after the 1.0 mg DST, and nine patients (45%) and one control (5%) were nonsuppressors after the 0.5 mg DST. In addition, nine patients with major depression (nonendogenous subtype) and 15 patients with panic attacks also were studied using the 0.5 mg DST. Only 2 of these 24 patients (8%) were nonsuppressors. The results suggest that the single-sample 0.5 mg DST is more sensitive than the standard 1.0 mg DST, and the specificity of the modified test appears comparable to the standard form of the test.