The physiology of adrenal insufficiency

正在进行的方案旨在：1)制定健康志愿者对250 mcg Cortrosyn刺激试验的游离皮质醇和醛固酮反应的规范范围，并将这些反应与已知原发性和继发性肾上腺功能不全患者的反应进行比较；2)使用这些测试评估感染性休克危重患者的肾上腺功能；3)评估接受间歇性高剂量类固醇治疗的患者肾上腺功能不全的患病率。在研究3中，接受骨髓移植的患者在每月接受高剂量糖皮质激素治疗后，每个月进行cortrosyn试验和胰岛素耐量试验。4)评估改变蛋白状态对总皮质醇和游离皮质醇水平的影响，以评估肝硬化肾病综合征患者肾上腺功能不全。这些议定书没有得到充分利用，也没有公布间隔资料。

Ongoing protocols are designed to: 1) develop a normative range for the free cortisol and aldosterone responses to the 250 mcg Cortrosyn stimulation test in healthy volunteers and compare these responses to those of patients with known primary and secondary adrenal insufficiency 2) evaluate adrenal function in critically ill patients with septic shock using these tests and 3) evaluate the prevalence of adrenal insufficiency in patients receiving intermittent high doses of steroids. For study 3, patients undergoing bone marrow transplantation will undergo the cortrosyn tests as well as an insulin tolerance test at monthly intervals after receiving monthly high-dose glucocorticoids. 4)assess the effect of altered protein status on total and free cortisol levels in the evaluation of adrenal insufficiency in patients with cirrhosis and nephrotic syndrome. The protocols are not fully recruited and no interval information has been published.