低濃度血中ACTH測定の有用性について

概要

論文の詳細を見る
In the present study, the minimum level of plasma ACTH to maintain normal adrenocortical function (cortisol: >5 μg/dl) was studied in normal subjects and patients with hypothalamicpituitary-adrenal disease. Basal plasma ACTH levels in the early morning were 10～60 pg/ml and plasma cortisol levels were 5～20 μg/dl in normal subjects. In patients with hypopituitarism, ACTH levels were less than 10 pg/ml in patients with partial adrenocortical insufficiency (plasma cortisol levels: 1～4 μg/dl) and were less than 5 pg/ml in patients with complete adrenocortical insufficiency (cortisol levels: <1 μg/dl). In patients with adrenal Cushing's syndrome and isolated ACTH-deficinecy, ACTH levels were less than 1 pg/ml. Overnight dexamethasone suppression test revealed similar relation between plasma ACTH levels and cortisol levels in normal subjects. The plasma cortisol level was not increased by CRF test or insulin-induced hypoglycemia test in patients with hypopituitalism whose basal plasma ACTH levels were less than 5 pg/ml and peak levels were less than 10 pg/ml. These results suggest that more than 10 pg/ml of the plasma ACTH level is necessary to maintain the normal plasma cortisol level and that less than 5 pg/ml of the plasma ACTH level resulted in severe adrenocortical hypo function.
東京女子医科大学の論文
1996-07-25