促肾上腺皮质激素和糖皮质激素的分离

最近研究发现,垂体和肾上腺活性的调节方式不同于以往的观点,导致在胎儿期、婴幼儿期、成人期血浆促肾上腺皮质激素和皮质类同醇激素分泌水平的分离.越来越多的基础和临床研究表明,在危重症、感染和精神失常时会出现促肾上腺皮质激素和皮质醇水平的分离.其机制包括.肾.上腺敏感性的变化、异常的受体表达及细胞因子、血管活性因子、神经肽等对肾上腺功能的调节.分离的程度与感染、创伤、恶性疾病、抑郁的严重程度有关.促肾上腺皮质激素和皮质类固醇激素分泌分离的现象和临床密切相关,凶此应引起重视.

Dissociation of ACTH and glucocorticoids

Different regulation of pituitary and adrenal gland activation leads to the dissociation of plasma adrenocorticotropic hormone and corticosteroid secretion.An increasing number of preclinical and clinical studies report dissociation of adrenocorticotropic hormone and cortisol levels in critical illness,inflammarion and mental disorders.Mechanisms involve an altered adrenal sensitivity,aberrant receptor expression or modulation of adrenal function by cytokines,vasoactive factors or neuropeptides.The degree of dissociation has been associated with the level of complications of sepsis,surgery,malignant disease and depression.The separation of adrenocorticotropic hormone and corticosteroid secretion is of clinical relevance and should be incorporated into our view on endocrine stress regulation.