静脉注射纳络酮对正常人和垂体-肾上腺疾病患者ACTH和皮质醇分泌的影响  

EFFECT OF NALOXONE ON SECRETION OF ACTH AND CORTISOL IN NORMAL SUBJECTS AND PATIENTS WITH PITUITARYADRENAL DISORDRES

作　　者：郭爱丽[1] 陆召麟[1] 史轶蘩[1] 

机构地区：[1]北京协和医院内分泌科,100730

出　　处：《中华内分泌代谢杂志》1991年第4期207-210,共4页Chinese Journal of Endocrinology and Metabolism

摘　　要：以血清N-POMC水平作为ACTH分泌的指标,观察了静脉注射大剂量(16mg)和小剂量(0.4mg)纳络酮(naloxone)对正常人和多种垂体-肾上腺疾病患者ACTH和皮质醇分泌的作用。在正常人注射大剂量纳络酮后30、60和90分钟时血清N-POMC和血浆皮质醇水平较生理盐水对照试验显著升高(P<0.02～0.001),但小剂量无效。Addison病和先天性肾上腺皮质增生症患者,注射大剂量纳络酮后,血清N-POMC的反应与正常人相似;小剂量也无此作用。但是,大、小剂量纳络酮均不能改变Cushing病或Nelson综合征患者血N-POMC和皮质醇水平。结果提示:纳络酮对于ACTH分泌的作用是通过了对其不敏感的δ-阿片肽受体起效的;Cushing病和Nelson综合征患者血ACTH分泌不受纳络酮的影响,可能是因为存在着自主或相对自主的垂体ACTH分泌瘤。The effect of high (16 mg) and low (0.4 mg) dose of naloxone on ACTH (N-POMC as its marker) and cortisol ecretion was studied in patients with pituitary-adrenal disorders and normal subjects as control. In eight normal sub- cts the high dose of naloxone caused significant increases of serum N-POMG and plasma cortisol concentrations at 30, 60 and 90 minutes (P<0.02～0.001) compared with that after injection of 0.9% saline, whereas the low dose of naloxone was ineffective. Similar response of blood N-POMC to high dose of naloxone wae found in five patients with Addison's disease and four patients with congenital adrenal hyperplasia. But both doses of naloxone failed to influence blood N-POMC and cortisol levels in eight patients with ACTH dependent Cushing's disease or Nelson's syndrome. These results suggest that inhibitory δ-opiate receptors (insensitive to naloxone) are involved in the regulation of ACTH secretion. In patients with Cushing's disease or Nelson's syndrome ACTH secretion is not influenced by naloxone, presumably because of an autonomous pituitary adenoma.

关 键 词：纳络酮 肾上腺病 皮质醇 

分 类 号：R586.02[医药卫生—内分泌]