快速ACTH刺激试验及其初步临床应用  

The rapid ACTH stimulation test and the initial clinical application

作　　者：彭俊英[1] 陆召麟[1] 郭爱丽[1] 

机构地区：[1]中国医学科学院北京协和医院内分泌科

出　　处：《北京医学》1994年第6期323-327,共5页Beijing Medical Journal

摘　　要：本研究以血浆皮质醇（血Ｆ）为指标，观察正常人、Ａｄｄｉｓｏｎ病、Ｓｈｅｅｈａｎ综合征及Ｃｕｓｈｉｎｇ综合征患者对静注２５０μｇβ１－２４ＡＣＴＨ的反应，２０例正常人静注β１－２４ＡＣＴＨ２５０μｇ后，血Ｆ显著升高。２例Ａｄｄｉｓｏｎ病病人对β１－２４ＡＣＴＨ刺激３天，均没有反应，１０例Ｓｈｅｅｈａｎ综合征病人，血Ｆ对β１－２４ＡＣＴＨ反应呈延迟或正常反应，１１例Ｃｕｓｈｉｎｇ病患者，血Ｆ对β１－２４ＡＣＴＨ反应的最大升高倍数与正常人比较，无显著性差异（Ｐ＞０．０５）；３例肾上腺腺瘤及３例异位ＡＣＴＨ综合征病人，血Ｆ对β１－２４ＡＣＴＨ刺激无反应。结果提示：３日法的快速ＡＣＴＨ刺激试验可以鉴别原发性与继发性肾上腺皮质功能低下症，Ｃｕｓｈｉｎｇ综合征病人中，那些对β１－２４ＡＣＴＨ无反应的患者要高度怀疑肾上腺腺瘤或异位ＡＣＴＨ综合征。The response to rapid ACTH stimulation test(250 μgβ1-24ACTH,iv bolus)was measured with indices of serum F in normals and patients with primary and secondary adrenal insufficiency,and Cushing's syndrome.In 20 normals, serum F level increased after β1-24ACTH iv 3-day rapid ACTH test was performed in patients with primary and secondary adrenal insufficiency, the results showed that had no response in 2 patients with Addison's disease.10 cases of Sheehan's syndrome showed the delayed or normal response.11 cases Cushing's disease,the increase of serum F after β1-24ACTH iv was no different from normals(P<0.05).No response of serum F was found toβ1-24ACTH stimulation in 3 cases with adrenal adenoma and 3 cases of ectopic ACTH syndrome We conclude 3day rapid ACTH stimulation test can differentiate between primary and secondary adrenal insufficiency. If the patients with Cushing's syndrome have no response toβ1-24ACTH stimulation,the adenoma or ectopic ACTH syndrome should be highly suspected.

关 键 词：ACTH 刺激试验 阿狄森综合征 临床应用 

分 类 号：R446.112[医药卫生—诊断学]