在创伤后应激障碍中，使用促肾上腺皮质激素（ACTH）对皮质醇给药的反应来检测皮质醇负反馈抑制的改变。
Alterations in cortisol negative feedback inhibition as examined using the ACTH response to cortisol administration in PTSD.
作者信息
Yehuda Rachel, Yang Ren-Kui, Buchsbaum Monte S, Golier Julia A
机构信息
The Traumatic Stress Studies Program, Psychiatry Department, Mount Sinai School of Medicine, and the Bronx Veterans Affairs Medical Center, 130 West Kingsbridge Road, Bronx, NY 10468, USA.
出版信息
Psychoneuroendocrinology. 2006 May;31(4):447-51. doi: 10.1016/j.psyneuen.2005.10.007. Epub 2005 Dec 20.
OBJECTIVE
Studies using the dexamethasone suppression test (DST) have demonstrated an enhanced negative feedback inhibition at the pituitary in PTSD, but have not provided information about central feedback effects, since dexamethasone (DEX) does not penetrate the brain well. The authors therefore examined the change in ACTH and cortisol before and after cortisol administration, which acts at central feedback sites in addition to peripheral targets.
METHOD
Blood was obtained from 31 male veterans (18 with PTSD) before, and 8, 40 and 95 min following injection of 17.5 mg cortisol and placebo.
RESULTS
A greater decline in ACTH was observed after cortisol injection in PTSD.
CONCLUSIONS
Central as well as peripheral negative feedback inhibition may be altered in PTSD.
目的
使用地塞米松抑制试验（DST）的研究表明，创伤后应激障碍（PTSD）患者垂体的负反馈抑制增强，但由于地塞米松（DEX）不易透过血脑屏障，尚未提供有关中枢反馈作用的信息。因此，作者研究了注射皮质醇前后促肾上腺皮质激素（ACTH）和皮质醇的变化，皮质醇除作用于外周靶点外，还作用于中枢反馈位点。
方法
对31名男性退伍军人（18名患有PTSD）在注射17.5mg皮质醇和安慰剂之前、之后8、40和95分钟采集血液。
结果
PTSD患者注射皮质醇后ACTH下降幅度更大。
结论
PTSD患者的中枢和外周负反馈抑制可能发生改变。
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