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本文报告13例原发肾上腺皮质功能减退(PAF)患者,31例继发肾上腺皮质功能减退(SAF)患者及42例正常人血浆ACTH及血清皮质醇测定的结果。血浆ACTH:PAF组显著高于正常组,SAF组显著低于正常组。PAF组与SAF组或正常组无重叠,但SAF组与正常组有较多重叠(83.9％)。血清皮质醇:PAF组、SAF组均显著低于正常组;PAF和SAF两组相似,与正常组有少量重叠(13.6％)。其中14例SAF、3例PAF和13例正常人做了氨基导眠能(AG)试验。SAF和正常人两组服AG后血浆ACTH的重叠现消失。本文结果表明:血清皮质醇是诊断肾上腺皮质功能减退的直接证据,但不能鉴别PAF和SAF,而血浆ACTH可以鉴别两者;氨基导眠能试验有助于鉴别SAF和正常人。
This article reports the results of the determination of plasma ACTH and serum cortisol in 13 patients with primary adrenal insufficiency (PAF), 31 patients with secondary adrenal insufficiency (SAF), and 42 normal subjects. Plasma ACTH: PAF group was significantly higher than the normal group, SAF group was significantly lower than the normal group. There was no overlap between PAF group and SAF group or normal group, but SAF group had more overlap with normal group (83.9%). Serum cortisol: PAF group, SAF group were significantly lower than the normal group; PAF and SAF groups were similar, with a slight overlap with the normal group (13.6%). Among them, 14 cases of SAF, 3 cases of PAF, and 13 cases of normal subjects performed aminolevin (AG) test. The overlap of plasma ACTH disappeared between AGF and normal subjects after AG treatment. The results of this article show that serum cortisol is a direct evidence for the diagnosis of adrenocortical insufficiency, but PAF and SAF can not be identified, and plasma ACTH can identify the two; amino-guided sleep can help identify SAF and normal people.