Chapman P S, Mooney C T, Ede J, Evans H, O'Connor J, Pfeiffer D U, Neiger R
Department of Veterinary Clinical Sciences, Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield, Hertfordshire AL9 7TA.
Vet Rec. 2003;153(25):771-5.
Serum concentrations of 17-hydroxyprogesterone and cortisol were measured before and after the administration of exogenous adrenocorticotrophic hormone (ACTH) to three groups of dogs: 27 healthy dogs (group 1), 19 dogs with non-adrenal illness (group 2) and 46 dogs with hyperadrenocorticism (group 3). The median (range) post-ACTH concentrations of 17-hydroxyprogesterone were 5.0 (22.2 to 16.8), 6.9 (2.0 to 36.2) and 14.4 (1.7 to 71) nmol/litre in groups 1, 2 and 3, respectively. There were no significant differences in the basal or post-ACTH concentrations of cortisol or 17-hydroxyprogesterone between groups 1 and 2. The post-ACTH concentrations of 17-hydroxyprogesterone in group 3 were significantly (P<0.001) greater than those in groups 1 and 2 combined. The area under the receiver operating curve (ROC) for the post-ACTH concentration of cortisol (0.94) was significantly greater than that for the post-ACTH concentration of 17-hydroxyprogesterone (0.76). Using a two-graph ROC analysis, a cut-off of 8.5 nmol/litre was found to maximise both the sensitivity and specificity of the post-ACTH concentration of 17-hydroxyprogesterone for the diagnosis of hyperadrenocorticism at 71 per cent. With a cut-off of 4.5 nmol/litre the sensitivity increased to 90 per cent but the specificity decreased to 40 per cent; with a cut-off of 16.7 nmol/litre the specificity increased to 90 per cent but the sensitivity decreased to 47 per cent.
对三组犬在给予外源性促肾上腺皮质激素（ACTH）前后测量血清17-羟孕酮和皮质醇浓度：27只健康犬（第1组）、19只患有非肾上腺疾病的犬（第2组）和46只患有肾上腺皮质功能亢进的犬（第3组）。第1组、第2组和第3组ACTH给药后17-羟孕酮的中位数（范围）浓度分别为5.0（2.2至16.8）、6.9（2.0至36.2）和14.4（1.7至71）nmol/升。第1组和第2组之间皮质醇或17-羟孕酮的基础浓度或ACTH给药后浓度无显著差异。第3组ACTH给药后17-羟孕酮的浓度显著高于第1组和第2组合并后的浓度（P<0.001）。皮质醇ACTH给药后浓度的受试者工作特征曲线（ROC）下面积（0.94）显著大于17-羟孕酮ACTH给药后浓度的曲线下面积（0.76）。使用双图ROC分析，发现17-羟孕酮ACTH给药后浓度诊断肾上腺皮质功能亢进的临界值为8.5 nmol/升时，敏感性和特异性均达到最高，为71%。临界值为4.5 nmol/升时，敏感性增至90%，但特异性降至40%；临界值为16.7 nmol/升时，特异性增至90%，但敏感性降至47%。
