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应用化学免疫发光法分组测定10例严重全身性感染(危重组)和12例感染性休克(休克组)患者在病程早期(确诊后1,3,5d)血清皮质醇和血浆ACTH水平,与12例对照组患者进行对照分析;并进行1μg ACTH刺激试验评价严重感染患者下丘脑-垂体-肾上腺(HPA)轴功能。结果显示,与对照组相比,危重组的ACTH明显升高(P<0.05)。休克组的ACTH明显降低(P<0.05),ACTH与严重感染患者的病情危重程度密切相关(P<0.05),在存活组和死亡组间存在显著差异(P<0.05)。提示HPA轴在严重感染发生早期已经出现功能改变,ACTH水平与严重感染患者的病情危重程度及住院病死率密切相关。
Serum cortisol and plasma ACTH levels were measured by chemiluminescence immunoassay in 10 patients with severe systemic infection (critically ill group) and 12 septic shock patients (shock group) at the early course of disease (1,3,5d after diagnosis), and 12 patients Control group patients were controlled analysis; and 1μg ACTH stimulation test for severe infection of the hypothalamus - pituitary - adrenal (HPA) axis function. The results showed that compared with the control group, ACTH in critically ill patients was significantly higher (P <0.05). ACTH in shock group was significantly lower than that in shock group (P <0.05). ACTH was closely related to the severity of illness in severe infection (P <0.05), and there was significant difference between survival group and death group (P <0.05). It suggested that the HPA axis had a functional change in the early stage of severe infection. The level of ACTH was closely related to the severity of illness and hospital mortality in severely infected patients.