血浆ACTH测定在柯兴氏综合征鉴别诊断中的价值

本文报告经手术、病理证实的24例柯兴氏综合征患者血浆 ACTH 水平的改变,并与大剂量地塞米松抑制试验作了比较。结果表明17例柯兴氏病患者中14例血浆 ACTH(8am)水平增高,3例正常高限,0 am ACTH 水平全部增高,且无昼夜节律变化;6例肾上腺皮质腺瘤血浆ACTH 均明显降低;1例异位 ACTH 综合征血浆 ACTH 异常增高。三组之间无一例重叠,与手术、病理的符合率为100%。大剂量地塞米松抑制试验的符合率为67～70.6%。提示血浆 ACTH 测定是鉴别柯兴氏综合征病因十分可靠的方法。

Plasma ACTH determination in the differential diagnosis of Cushing''''s syndrome

Plasma ACTH concentrations were determined by RIA in 24 cases of Cushing's syndrome de- monstrated by operation and pathology,and were compared with the results of large dose dexam- ethasone suppression test.It was showed that plasma ACTH levels were elevated in 14 cases of Cushing's disease,in high normal limit in 3 cases of Cushing's disease at 8am,and were elevated in all cases at Oam,remarkedly decreased in all 6 cases of adrenal adenoma,and very high in one case of ectopic ACTH syndrome.The results of plasma ACTH levels showed no overlap in all the three diseases.The concordance rate with operation and pathology for plasma ACTH was 100%, while it was from 67 to 70.6% for dexamethasone suppression test.It is suggested that plasma ACTH determination is a reliable method in the differentiation of causes of Cushing's syndrome.