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测定血浆促肾上腺皮质激素(ACTH)的最大价值在于鉴别皮质醇增多症(柯兴氏综合征)的病因。因为从肾上腺肿瘤患者的血浆中不能检出ACTH,而在垂体性皮质醇增多症和异位ACTH分泌综合征患者的血浆中却可检出ACTH。未经治疗的垂体性皮质醇增多症患者,血浆ACTH水平早晨在正常范围内(但24小时分泌的正常波动周期消失)或略有增高(即在200微微克/毫升以上),异位ACTH分泌综合征患者,血浆ACTH水平常显著升高。由于许多垂体性皮质醇增多症者早晨血浆ACTH水平正常,因此,除非血浆ACTH水平很高,否则,单
The greatest value in measuring plasma adrenocorticotropic hormone (ACTH) is to identify the cause of hypercortisolism (Cushing’s syndrome). Because ACTH cannot be detected in the plasma of adrenal tumor patients, ACTH can be detected in the plasma of patients with pituitary hypercortisolism and ectopic ACTH secretion syndrome. In untreated patients with pituitary hypercortisolism, plasma ACTH levels are within normal range in the morning (but the normal fluctuation cycle of 24-hour secretion disappears) or slightly higher (ie, above 200 pg/ml), and ectopic ACTH secretion. In patients with syndrome, plasma ACTH levels are often significantly elevated. Since many patients with pituitary hypercortisemia have normal levels of plasma ACTH in the morning, unless plasma ACTH levels are high,