血浆ACTH测定在柯兴综合征鉴别诊断中的价值

报告经手术、病理证实的24例柯兴综合征患者血浆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,柯兴病患者17例中14例血浆ACTH(上午8点)水平增高,3例正常高限,0点AGTH全部升高,且无昼夜节律变化;肾上腺皮质腺瘤6例血浆AGTH均明显降低;异位ACTH综合征1例血浆ACTH异常升高。3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AGTH测定是鉴别柯兴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 Gushing's syndrome confirmed by operation and pathology,and were compared with the results of large dose dexamethasone 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 8 am,and were elevated in all cases at 0 am,and remarkably decreased in all 6 cases of adrenal adenoma,and very high in one case of ectopic ACTH syndrome.The results of plasma ACTH levels did not show overlapping in three diseases.The coincidence 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 be a reliable method in the differential diagnosis of causes of Cushing's syndrome.