垂体后叶素的CRH试验在库欣综合征诊断中的应用  

Application of CRH test to the diagnosis of Cushing's disease

作　　者：王曙[1] 罗邦尧[1] 许曼音[1] 陈家伦 金静芬 金燕 陈淑贤 崔贤德[1] 万春梅[1] 杨秀英[1] 

机构地区：[1]上海第二医科大学瑞金医院内分泌科,200025 [2]上海市内分泌研究所,200025

出　　处：《上海医学》1997年第5期249-252,共4页Shanghai Medical Journal

摘　　要：本文用垂体后叶素和hCRH对正常人（5例）、库欣病（12例）、肾上腺腺瘤（4例）做联合的CRH试验，结果在正常人ACTH与血皮质醇均显著增加（P＜0．01）。在所有12例增生病人中，ACTH与血F均在已增高的基础值上进一步升高（P值均＜0．01），未见假阴性结果。而4例腺瘤病人，联合试验使血浆ACTH稍有升高，而血F不增高。在比较增生与腺瘤病人的ACTH与血F峰值与基值差的绝对值（△）时，发现增生病人△ACTH＞20pg／ml，△F＞7μg／ml；反之则为腺瘤。This study was designed to examine the combined effect of posterior pituitary hormone (0. 33 u iv) and hCRH (1μg/kg tv) on ACTH and plasma cortisol release in the normal subjects (n＝5) and to investigate the clinical use of this combination test in Cushing's disease (n＝12) and adrenal adenoma n＝4. The results revealed that in normal subjects the level of ACTH and plasma cortisol were significantly increased (P<0. 01)after the combined administration of hCRH and posterior pituitary hormone. In Cushing's disease patients (n= 12), it caused a further increase in the already elevated level of ACTH (P<0. 01 )and cortisol (PR0. 01 )No false negative result was appeared. In 4 cases of adrenal adenoma, although the percentage of increase ACTH release was up to 33%, the peak ACTH level in adrenal adenoma patients was much lower than that in the Cushing's disease patients (P＜0. 01 ). And the plasma cortisol levels were not remarkably increased. We found that the absolute value (△) of ACTH and F between peak and base were more than 20 pg/ml (△ACTH) and 7 μg/dl (△F) in Cushing's disease, while in adrenal adenoma they were less than 20 pg/ml (△ACTH) and 7 μg/dl (△F).

关 键 词：垂体后叶素 CUSHING综合征 诊断 hCRH 

分 类 号：R586.204[医药卫生—内分泌]