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中华结核和呼吸杂志 1992年第5期15卷 300页

作者：阎世明孙秀娟邹志艳安龙浩赵春海 (?)淑云周善德高风桐孙文伟叶慧君长春市结核病医院白求恩医科大学第三临床医院

肺结核患者的肾上腺功能,自60年代起就已被临床所关注。伹缺乏系统地报道。我们为探索肺结核患者垂体-肾上腺皮质功能,应用放射免疫法检测了100例肺结核患者血清皮质醇、醛固酮和促肾上腺皮质激素(ACTH)的水平。对象:肺结核100例系临床... 详细信息

肺结核患者的肾上腺功能,自60年代起就已被临床所关注。伹缺乏系统地报道。我们为探索肺结核患者垂体-肾上腺皮质功能,应用放射免疫法检测了100例肺结核患者血清皮质醇、醛固酮和促肾上腺皮质激素(ACTH)的水平。对象:肺结核100例系临床确诊的住院患者,男63例,女37例,平均年龄46岁。菌阳者43例,菌阴者42例,病情稳定者15例。健康对照组30人,男16人,女14人,平均年龄46岁。方法:研究对象于上午8时抽取血清样本。血清皮质醇、醛固酮和ACTH均为放射免疫法测定。三种药盒均由美国DPC公司所提供。结果:1.肺结核患者与健康组皮质醇、醛固酮和ACTH比较见附表。

关键词：促肾上腺皮质激素/血液结核肺/血液醛固酮/血液

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补肾益气安胎法治疗肾虚型早期先兆流产的临床研究

补肾益气安胎法治疗肾虚型早期先兆流产的临床研究

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作者：黄健妹福建中医学院

学位级别：硕士

目的：观察中药补肾益气安胎法对肾虚型早期先兆流产患者血清促肾上腺皮质激素释放激素(CRH)、孕酮(P)、绒毛膜促性腺激素(β-HCG)的影响，探讨其保胎的机理、优势，及CRH作为早期先兆流产观测指标之一的临床意义。方法：将60例符合病... 详细信息

目的：观察中药补肾益气安胎法对肾虚型早期先兆流产患者血清促肾上腺皮质激素释放激素(CRH)、孕酮(P)、绒毛膜促性腺激素(β-HCG)的影响，探讨其保胎的机理、优势，及CRH作为早期先兆流产观测指标之一的临床意义。方法：将60例符合病例选择标准的先兆流产患者按随机数字表法分为两组：中药组30例、中西药结合组30例：另随机选取正常早孕者30例作为正常组，只测定其血清P、β-HCG、CRH水平，以便对照。中药组口服补肾益气安胎中药，中西药结合组肌注黄体酮、HCG，另加服中药。治疗2周后，对照观察治疗前后血清P、β-HCG、CRH水平变化、孕囊大小变化、中医证候积分变化、临床症状消失情况、总体疗效，用统计学分析两组间各项指标的差异。结果：1．中药组和中西药结合组均能显著提升患者血P、β-HCG水平，两组治疗前后比较均有显著性差异(P＜0.05)；两组治疗后比较无显著性差异(P＞0.05)，与正常组比较亦无显著差异(P＞0.05)。2．中药组和中西药结合组总有效率分别为93.33％和96.67％，无显著性差异(P＞0.05)；经治疗后两组证候积分均明显下降，与治疗前比较有显著性差异(P＜0.05)，但两组治疗后比较无显著性差异(P＞0.05)。3．正常组前后两次、中药组及中西药组治疗前后的CRH结果比较，无显著性差异(P＞0.05)。4．经治疗后，中药组、中西药结合组的孕囊直径均见明显增长，与治疗前比较有显著性差异(P＞0.05)；两组治疗后比较，无显著性差异(P＜0.05)。结论：1．补肾益气安胎中药配伍合理，药性柔和，能有效提升血孕酮、β-HCG水平以达保胎效果，且无明显毒副反应，对早期先兆流产有很好疗效。2．补肾益气安胎中药在总体疗效及改善中医证候疗效方面，与中西药结合组无显著性差异，在临床保胎上，可尽量使用中药，以避免使用西药的一些弊端。3．将CRH作为早期先兆流产的一个观测指标，无太大临床意义。

关键词：流产,先兆/中药疗法流产,先兆/中西医结合疗法孕酮/血液绒毛膜促性腺激素,B亚单位,人/血液促肾上腺皮质激素/血液随机对照试验

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性早熟女童血浆ghrelin水平与腺垂体激素的关系

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浙江大学学报（医学版） 2008年第5期37卷 506-510页

作者：朱红陈黎勤蒋优君梁黎浙江大学医学院附属儿童医院内分泌科浙江杭州310003

目的：探讨性早熟女童血浆ghrelin与腺垂体激素的关系。方法：84例年龄在6-9岁的性早熟女童根据第二性征发育情况、骨龄、子宫、卵巢容积及GnRH激发试验的结果分为特发性中枢性早熟（ICPP）和单纯乳房早发育（PT）组,采用放射免疫法测... 详细信息

目的：探讨性早熟女童血浆ghrelin与腺垂体激素的关系。方法：84例年龄在6-9岁的性早熟女童根据第二性征发育情况、骨龄、子宫、卵巢容积及GnRH激发试验的结果分为特发性中枢性早熟（ICPP）和单纯乳房早发育（PT）组,采用放射免疫法测定性早熟女童空腹血浆ghrelin水平,化学发光法测定ACTH、TSH、PRL、GH、LH、FSH,并与对照组比较。结果：1ICPP组血浆ghrelin为Log（2.42±0.26）ng/L,明显低于PT组和对照组[Log（2.62±0.21）ng/L,Log（2.58±0.44）ng/L,P〈0.05];而对照组与PT组两组之间比较差异无显著性（P〉0.05）。2TannerⅢ期的ICPP女童ghrelin为Log（2.31±0.24）ng/L明显低于TannerⅡ期的ICPP女童[Log（2.53±0.24）ng/L,P〈0.05]。3经双变量相关分析,性早熟女童血浆ghrelin水平与ACTH、PRL及GnRH激发后的LH15、LH30、LH60呈负相关（r分别为-0.248、-0.235、-0.445、0.405、0.398,均P〈0.05）;而与GH、GnRH激发后的FSH15及LH0^-2、FSH0^-2无相关。结论：ICPP女童血浆ghrelin水平下降,TannerⅢ期女童血浆ghrelin低于TannerⅡ期,GnRH激发后与LH呈负相关。这可能与性启动有关。

关键词：垂体激素类,前叶青春期,早熟肽类激素/血液促黄体激素/血液雌二醇/血液卵泡刺激素/血液促肾上腺皮质激素/血液促性腺素释放激素/类似物和衍生物

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参附注射液治疗慢性阻塞性肺疾病急性加重期的临床分析

参附注射液治疗慢性阻塞性肺疾病急性加重期的临床分析

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作者：徐国亮福建中医学院

学位级别：硕士

目的：评价参附注射液配合常规西医治疗慢性阻塞性肺疾病急性加重期（AcuteExacerbation of Chronic Obstructive Pulmonary Disease，AECOPD）的临床疗效及对肺功能、促肾上皮质激素、血清皮质醇和细胞免疫功能的影响，探讨温阳益气法... 详细信息

目的：评价参附注射液配合常规西医治疗慢性阻塞性肺疾病急性加重期（AcuteExacerbation of Chronic Obstructive Pulmonary Disease，AECOPD）的临床疗效及对肺功能、促肾上皮质激素、血清皮质醇和细胞免疫功能的影响，探讨温阳益气法在治疗AECOPD中的适用指征。方法：根据病例纳入标准收集2005年11月至2007年1月在我科住院的AECOPD患者67例，按就诊先后顺序随机分为治疗组（参附注射液+西药治疗组）37例和对照组（单纯西药治疗组）30例。根据中医辨证分型标准按标证分为寒证（含寒痰型和寒喘型）和热证（含热痰型和热喘型）两型。其中治疗组寒证17例，热证20例，对照组寒证13例，热证17例。两组患者均给予控制性氧疗、抗感染、解痉、化痰、平喘等常规西医治疗，治疗组加用参附注射液。所有患者分别于治疗前1天、治疗结束后第1天进行临床症状、体征评价和肺功能、血浆促肾上腺皮质激素、血清皮质醇、CD3、CD4、CD8检测，所有数据均应用统计软件SPSS 13.0进行统计分析。结果： 1．治疗组总体疗效和咳、痰、喘症状改善均优于对照组（p＜0.05），而肺部啰音的改善与对照组无显著性差异（p＞0.05）。提示参附注射液能提高AECOPD疗效。 2．经治疗后，两组肺功能均有明显改善（p＜0.01），但组间比较无显著性差异（p＞0.05），提示两组在肺功能改善方面的疗效相当。 3．经治疗后，血浆促肾上腺皮质激素和血清皮质醇水平均显著下降（P＜0.05），但治疗组下降程度小于对照组（P＜0.01），提示参附注射液能够兴奋肾上腺皮质功能，提高体内糖皮质激素水平。 4．治疗组经治疗后细胞免疫功能显著升高（p＜0.05），而对照组治疗前后免疫功能无显著改变（p＞0.05），提示参附注射液能在一定程度上增强AECOPD患者细胞免疫功能。 5．在中医证型疗效方面，两型的总体疗效无显著性差异（p＞0.05），提示参附注射液在寒热证AECOPD的疗效相当。 6．两组治疗过程中未出现严重的不良反应，提示常规西药治疗的情况下配合应用参附注射液安全可靠。结论： 1．参附注射液配合西医常规治疗AECOPD疗效优于单纯西医治疗组。 2．参附注射液具有提高体内糖皮质激素水平、增强细胞免疫功能的作用，其为佐治AECOPD有效的部分机制。 3．通过证型间比较，临床疗效和副反应无显著性差异，患者耐受性良好，提示参附注射液适用于寒、热证AECOPD患者。 4．温阳益气法治疗AECOPD值得今后进一步深入研究。

关键词：肺疾病,慢性阻塞性/中西医结合疗法温阳益气促肾上腺皮质激素/血液羟基皮质甾醇类/血液临床对照试验 @参附注射液

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ACTH and cortisol release following intravenous desmopressin: a dose-response study

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CLINICAL ENDOCRINOLOGY 1999年第5期51卷 653-658页

作者： Scott, LV Medbak, S Dinan, TG St James Hosp Trinity Coll Sch Med Dept Psychiat Dublin 8 Ireland Queen Alexandra Hosp Dept Chem Pathol Portsmouth Hants England Univ London St Bartholomews Hosp Med Coll Dept Psychol Med London England

OBJECTIVE Desmopressin (DDAVP) is a synthetic analogue of AVP, the companion regulator of corticotrophin-releasing hormone (CRH) in the control of ACTH synthesis and release from the pituitary corticotrophs. The body of evidence from human studies suggests that DDAVP alone, unlike AVP, does not bring about ACTH release, although recent evidence suggests idiosyncracies of response in healthy subjects. We examined whether DDAVP exerted any consistent effect on ACTH and cortisol release, and also if this occurred in a dose-dependent manner. DESIGN AND SUBJECTS A total of 18 subjects participated in the study. Saline, 5 mu g, 10 mu g and 15 mu g DDAVP were administered as an intravenous bolus at 1300 h;5, 7, 18 and 8 subjects, respectively, participated in each arm of the study. Plasma ACTH and cortisol responses were measured over a 120-minutes period. RESULTS Significant between group comparisons were demonstrated for both ACTH (P < 0.05) and cortisol responses (P < 0.005) measured as maximum increment from baseline. The ACTH response to 5, 10 and 15 mu g DDAVP was significantly greater than saline at all three doses, whilst maximal responses were seen at 10 mu g, The cortisol responses to 10 and 15 mu g DDAVP doses, but not 5 mu g, were significantly greater than following saline. 11/18 subjects were deemed 'responders' following 10 mu g DDAVP on the basis of both ACTH and cortisol output. CONCLUSIONS This data suggests that DDAVP is capable of stimulating ACTH and cortisol release when administered alone as a bolus in over 50% of healthy subjects. This is in contrast to much of the extant literature. The mode of administration may be pertinent to this effect. This finding has implications for the recent focus on DDAVP as a diagnostic toot in disorders such as Cushing's Disease.

关键词：促肾上腺皮质激素/血液方差分析曲线下面积脱氨基精氨酸血管升压素剂量效应关系药物双盲法用药计划表氢化可的松/血液肾脏用药成年人女(雌)性人类男(雄)性

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Oral administration of a corticotropin-releasing hormone receptor antagonist significantly attenuates behavioral, neuroendocrine, and autonomic responses to stress in primates

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PROCEEDINGS OF THE NATIONAL ACADEMY OF SCIENCES OF THE UNITED STATES OF AMERICA 2000年第11期97卷 6079-6084页

作者： Habib, KE Weld, KP Rice, KC Pushkas, J Champoux, M Listwak, S Webster, EL Atkinson, AJ Schulkin, J Contoreggi, C Chrousos, GP McCann, SM Suomi, SJ Higley, JD Gold, PW NIMH Clin Neuroendocrinol Branch Intramural Res Program NIH Bethesda MD 20892 USA NIDDKD Med Chem Lab Intramural Res Program NIH Bethesda MD 20892 USA NIH Clin Ctr Pharm NIH Bethesda MD 20892 USA NICHHD Pediat & Reprod Endocrinol Branch Intramural Res Program NIH Bethesda MD 20892 USA NIAAA Clin Studies Lab Primate Unit Intramural Res Program Poolesville MD 20837 USA NICHHD Comparat Ethol Lab Intramural Res Program NIHAnim Ctr Poolesville MD 20837 USA NIDA Brain Imaging Unit Intramural Res Program Baltimore MD 21224 USA Louisiana State Univ Pennington Biomed Res Ctr Baton Rouge LA 70808 USA

We evaluated the effects of the lipophilic nonpeptide corticotropin-releasing hormone (CRH) type 1 receptor antagonist antalarmin on the behavioral, neuroendocrine, and autonomic components of the stress response in adult male rhesus macaques. After oral administration, significant antalarmin concentrations were detected in the systemic circulation and the cerebrospinal fluid by a mass spectrometry-gas chromatography assay developed specifically for this purpose. Pharmacokinetic and dose response studies suggested that an oral dose of 20 mg/kg was optimal for behavioral and endocrine effects. We then administered this dose in a double-blind, placebo-controlled fashion to monkeys exposed to an intense social stressor: namely, placement of two unfamiliar males in adjacent cages separated only by a transparent Plexiglas screen. Antalarmin significantly inhibited a repertoire of behaviors associated with anxiety and fear such as body tremors, grimacing, teeth gnashing, urination, and defecation. In contrast, antalarmin increased exploratory and sexual behaviors that are normally suppressed during stress. Moreover, antalarmin significantly diminished the increases in cerebrospinal fluid CRH as well as the pituitary-adrenal, sympathetic, and adrenal medullary responses to stress. We conclude that CRH plays a broad role in the physiological responses to psychological stress in primates and that a CRH type 1 receptor antagonist may be of therapeutic value in human psychiatric, reproductive, and cardiovascular disorders associated with CRH system hyperactivity.

关键词：投药口服促肾上腺皮质激素/血液抗焦虑药/投药和剂量抗焦虑药/药理学抗焦虑药/治疗应用焦虑/药物疗法焦虑/病因学精氨酸加压素/脑脊髓液促肾上腺皮质素释放激素/脑脊髓液促肾上腺皮质素释放激素/生理学双盲法药物评价临床前肾上腺素/血液探究行为/药物作用恐惧/药物作用氢化可的松/血液下丘脑-垂体系统/药物作用下丘脑-垂体系统/病理生理学猕猴去甲肾上腺素/血液垂体肾上腺系统/药物作用垂体肾上腺系统/病理生理学嘧啶类/投药和剂量嘧啶类/药理学嘧啶类/治疗应用吡咯类/投药和剂量吡咯类/药理学吡咯类/治疗应用受体促肾上腺皮质素释放激素/拮抗剂和抑制剂受体促肾上腺皮质素释放激素/生理学性行为动物/药物作用社会优势应激心理学/药物疗法应激心理学/代谢应激心理学/病理生理学应激心理学/心理学动物男(雄)性

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Tall stature in familial glucocorticoid deficiency

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CLINICAL ENDOCRINOLOGY 2000年第4期53卷 423-430页

作者： Elias, LLK Huebner, A Metherell, LA Canas, A Warne, GL Bitti, MLM Cianfarani, S Clayton, PE Savage, MO Clark, AJL St Bartholomews & Royal London Sch Med & Dent Dept Endocrinol London England Tech Univ Dresden Childrens Hosp D-8027 Dresden Germany Winthrop Univ Hosp Dept Paediat Endocrinol Mineola NY 11501 USA Royal Childrens Hosp Dept Endocrinol & Diabet Melbourne Vic Australia Univ Roma Tor Vergata Dept Paediat Rome Italy Univ Manchester Dept Med Endocrine Sci Res Grp Manchester Lancs England

OBJECTIVE Familial glucocorticoid deficiency (FGD) has frequently been associated with tall stature in affected individuals. The clinical, biochemical and genetic features of five such patients were studied with the aim of clarifying the underlying mechanisms of excessive growth in these patients. PATIENTS AND METHODS Five patients with a clinical diagnosis of FGD are described in whom the disorder resulted from a variety of novel or previously described missense or nonsense mutations of the ACTH receptor (MC2-R). All patients demonstrated excessive linear growth over that predicted from parental indices and increased head circumference. RESULTS Growth hormone and IGF-I-values were normal. Growth charts suggest that the excessive growth is reduced to normal following the introduction of glucocorticoid replacement. A characteristic facial appearance including hypertelorism, marked epicanthic folds and prominent frontal bossing was noted. CONCLUSIONS These findings indicate that ACTH resistance resulting from a defective ACTH receptor may be associated with abnormalities of cartilage and/or bone growth independently of the GH-IGF-I axis, but probably dependent on ACTH actions through other melanocortin receptors.

关键词：促肾上腺皮质激素/血液骨骼年龄测定身高糖皮质激素类/缺乏生长障碍/药物疗法生长障碍/遗传学氢化可的松/血液氢化可的松/治疗应用微卫星重复突变误义序列分析 DNA 儿童儿童学龄前人类婴儿婴儿新生男(雄)性

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A premature increase in circulating cortisol suppresses expression of 11β hydroxysteroid dehydrogenase type 2 messenger ribonucleic acid in the adrenal of the fetal sheep

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BIOLOGY OF REPRODUCTION 2000年第5期62卷 1297-1302页

作者： Ross, JT McMillen, IC Adams, MB Coulter, CL Univ Adelaide Dept Physiol Adelaide SA 5000 Australia

We have investigated the effect of intrafetal cortisol administration, before the normal prepartum cortisol surge, on the expression of 11 beta hydroxysteroid dehydrogenase (11 beta HSD) type 2 mRNA in the fetal adrenal, We also determined whether increased fetal cortisol concentrations can stimulate growth of the fetal adrenal gland or increase expression of adrenal steroidogenic enzymes. Cortisol (hydrocortisone succinate: 2.0-3.0 mg in 4.4 ml/24 h) was infused into fetal sheep between 109 and 116 days of gestation (cortisol infused;n 12), and saline was administered to control fetuses (saline infused;n = 13) at the same age. There was no effect of cortisol infusion on the fetal adrenal:body weight ratio (cortisol: 101.7 +/- 5.3 mg/kg;saline: 108.2 +/- 4.3 mg/kg), The ratio of adrenal 11 beta HSD-2 mRNA to 18S rRNA expression was significantly lower, however, in the cortisol-infused group (0.75 +/- 0.02) compared with the group receiving saline (1.65 +/- 0,14). There was no significant effect of intrafetal cortisol on the relative abundance of adrenal CYP11A1, CYP17, CYP21A1, and 3 beta HSD mRNA. A premature elevation in fetal cortisol therefore resulted in a suppression of adrenal 11 beta HSD-2. Increased intra-adrenal exposure to cortisol at this stage of gestation is, however, not sufficient to promote adrenal growth or steroidogenic enzyme gene expression.

关键词： 11-β-羟甾脱氢酶类肾上腺/解剖学和组织学肾上腺/胚胎学肾上腺/代谢促肾上腺皮质激素/血液体重胆固醇侧链断裂酶/遗传学细胞色素P450酶系统/遗传学酶类/药物作用酶类/代谢胎血/代谢氢化可的松/血液氢化可的松/药理学羟甾类脱氢酶类/药物作用羟甾类脱氢酶类/遗传学羟甾类脱氢酶类/代谢器官测量 RNA 信使/代谢绵羊/胚胎学类固醇17-α-羟化酶/遗传学动物女(雌)性妊娠

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Effects of the high-affinity corticotropin-releasing hormone receptor 1 antagonist R121919 in major depression:: the first 20 patients treated

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JOURNAL OF PSYCHIATRIC RESEARCH 2000年第3期34卷 171-181页

作者： Zobel, AW Nickel, T Künzel, HE Ackl, N Sonntag, A Ising, M Holsboer, F Max Planck Inst Psychiat D-80804 Munich Germany

Clinical and preclinical data suggest that unrestrained secretion of corticoctropin-releasing hormone (CRH) in the CNS produces several signs and symptoms of depression and anxiety disorders through continuous activation of CRH1 receptors. This led to the development of drugs that selectively antagonize CRH1 receptors suppressing anxiety-like behavior in rats and also in monkey models of anxiety. These findings led to a clinical development program exploring the antidepressive potential of R121919, a water-soluble pyrrolopyrimidine that binds with high affinity to human CRH1 receptors and is well absorbed in humans. This compound was administered to 24 patients with a major depressive episode primarily in order to investigate whether its endocrine mode of action compromises the stress-hormone system or whether other safety and tolerability issues exist. The patients were enrolled in two dose-escalation panels: one group (n = 10) where the dose range increased from 5-40 mg and another group (n = 10) where the dose escalated from 40 to 80 mg within 30 days each. Four patients dropped out because of withdrawal of consent to participate (three cases) or worsening of depressive symptomatology in one case. We found that R121919 was safe and well tolerated by the patients during the observation period. Moreover, the data suggested that CRH1-receptor blockade does not impair the corticotropin and cortisol secretory activity either at baseline or following an exogenous CRH challenge. We also observed significant reductions in depression and anxiety scores using both, patient and clinician ratings. These findings, along with the observed worsening of affective symptomatology after drug discontinuation, suggests that the pharmacological principle of CRH1-receptor antagonism has considerable therapeutic potential in the treatment and the prevention of diseases where exaggerated central CRH activity is present at baseline or following stress exposure. (C), 2000 Elsevier Science

关键词：促肾上腺皮质激素/血液方差分析抗焦虑药/投药和剂量抗焦虑药/药理学抗焦虑药/治疗应用促肾上腺皮质素释放激素/投药和剂量促肾上腺皮质素释放激素/代谢抑郁症更年期/血液抑郁症更年期/药物疗法抑郁症更年期/代谢抑郁症更年期/尿剂量效应关系药物药物评价氢化可的松/血液氢化可的松/尿精神病状态评定量表嘧啶类/药理学嘧啶类/治疗应用吡咯类/药理学受体促肾上腺皮质素释放激素/拮抗剂和抑制剂受体促肾上腺皮质素释放激素/代谢治疗结果成年人女(雌)性人类男(雄)性中年人

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Assessment of cortisol and ACTH responses to the desmopressin test in patients with Cushing's syndrome and simple obesity

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CLINICAL ENDOCRINOLOGY 1999年第4期51卷 473-477页

作者： Tsagarakis, S Vasiliou, V Kokkoris, P Stavropoulos, G Thalassinos, N Evangelismos Med Ctr Dept Diabet Endocrinol & Metab Athens 10676 Greece

OBJECTIVE The desmopressin test has recently been introduced in clinical practice as an adjunctive tool in the differential diagnosis of ACTH-dependent Cushing's syndrome (CS), It has been reported that the majority of patients with pituitary-dependent CS (Cushing's disease, CD) respond to desmopressin, while no such response is usually observed in other forms of this syndrome. In the present study, the responsiveness of the HPA axis to desmopressin was studied in a group of obese subjects. In addition, the ability of desmopressin administration to differentiate between patients with obesity and the various forms of Cushing's syndrome was investigated. DESIGN AND SUBJECTS Cortisol and ACTH responses to the administration of desmopressin (10 pg bolus i.v.) were examined in 20 consecutive patients with obesity (14 women and six men;BMI range: 34.5-66.7 kg/m(2)). Obese subjects had no clinical stigmata of GS, In all obese patients, either an overnight (dex 1 mg at 2300 h) (n = 8) or a formal low-dose (dex 0.5 mg 6-hourly for 2 days) (n=12) dexamethasone suppression test was performed for the exclusion of Cushing's syndrome, Three of eight subjects showed failure of cortisol suppression (i.e. F>28nmol/l) to the overnight dexamethasone suppression test, but they had undetectable cortisol levels (<28 nmol/l) on further testing with the formal P-day test, All but two of the remaining subjects had undetectable cortisol levels (<28 nmol/l) following the formal 2-day, low-dose, dexamethasone suppression test. For comparison, desmopressin responses were also tested in 33 patients with GS of varied aetiologies (25 patients with pituitary-dependent GS, three patients with occult ectopic ACTH secretion and five patients with primary adrenal GS). A positive response was considered to be an increment greater than 20% and 50% from baseline levels of cortisol and ACTH, respectively. RESULTS Mean cortisol (F) and ACTH levels did not differ from the baseline at any time point following

关键词：促肾上腺皮质激素/血液库欣综合征/血液库欣综合征/诊断库欣综合征/病理生理学脱氨基精氨酸血管升压素诊断鉴别氢化可的松/血液肥胖症/血液肥胖症/病理生理学垂体疾病/血液垂体疾病/诊断垂体疾病/病理生理学试验预期值肾脏用药成年人女(雌)性人类男(雄)性中年人

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