慢性阻塞性肺疾病急性发作期垂体-肾上腺皮质轴变化  

An Investigation of the Hormones Change of the Pituitary Body and Adrenal Cortex Index in the Exacerbative Stage of Patient with COPD

作　　者：郭剑超[1,2] 张宏[1,2] 张宁 张素贞[1,2] 马静 李慎果 

机构地区：[1]天津医科大学第二医院 [2]天津医药公司卫生所

出　　处：《中国慢性病预防与控制》1998年第6期289-291,共3页Chinese Journal of Prevention and Control of Chronic Diseases

摘　　要：为探讨慢性阻塞性肺疾病（ＣＯＰＤ）急性发作期肾上腺皮质功能及垂体－肾上腺皮质轴变化的关系，对５６例ＣＯＰＤ患者进行了血浆皮质醇（Ｆ）和促肾上腺皮质激素（ＡＣＴＨ）的测定。并依年龄组（３７～５９岁，６０～７５岁）及男女性别不同进行了比较，结果与正常对照组相比，不同年龄组３２例单纯ＣＯＰＤ患者Ｆ显著降低（Ｐ＜０．０５），ＡＣＴＨ增高（Ｐ＞０．０５），２４例合并肺心病患者Ｆ显著增高（Ｐ＜０．０５），ＡＣＴＨ降低（Ｐ＞０．０５），合并肺心病组与单纯ＣＯＰＤ组相比较Ｆ显著增高（Ｐ＜０．０５），血浆ＡＣＴＨ６０～７５岁年龄组显著降低（Ｐ＜０．０５），而３７～５９岁年龄组降低不明显（Ｐ＞０．０５）。男性ＣＯＰＤ组与正常组相比较Ｆ显著降低（Ｐ＜０．０５），ＡＣＴＨ增高（Ｐ＞０．０５），合并肺心病组较正常组及ＣＯＰＤ组均为Ｆ显著性增高（Ｐ＜０．０５），ＡＣＴＨ显著性降低（Ｐ＜０．０５）。但女性各组之间无显著性变化（Ｐ＞０．０５）。提示肺心病患者肾上腺皮质功能并不低下。ＡＣＴＨ降低可能与Ｆ对ＡＣＴＨ的负反馈作用有关。女性ＣＯＰＤ患者此变化不明显。To investigate the change of hormones and relationship between pituitary body and adrenal cortex in patient with COPD,56 COPD patients were checked with fludrocortisone(F) and adrenocorticotrophic hormone(ACTH).Compared by age and sex.F are all significantly lower in patients with COPD( P <0.05) and significantly higher in cor pulmonary( P < 0.05 ),ACTH significantly lower in 60￣75 age group.In male F is significantly lower in COPD ( P <0.05) and significantly higher in cor pulmonary( P <0.05).ACTH is significantly higher than in healthy groups and COPD groups( P <0.05).But there were not obviously changes of F and ACTH in female.The results indicated that there was no hypoadrenocorticism in the patients of cor pulmonary.To suppose F have a negative feed back effect to ACTH and leads to it lower.There were changes of hormones level of pituitary body and adrenal cortex along with the development course of COPD to cor pulmonary special in male.

关 键 词：慢性 阻塞性肺疾病 肺心病 皮质醇 ACTH 

分 类 号：R563.02[医药卫生—呼吸系统]