Soszynski P, Slowinska-Srzednicka J, Kasperlik-Zaluska A, Zgliczynski S
Department of Endocrinology, Medical Centre for Postgraduate Education, Warsaw, Poland.
J Endocrinol. 1991 Jun;129(3):453-8. doi: 10.1677/joe.0.1290453.
In order to investigate the effect of chronic hypercortisolaemia on endogenous natriuretic factors (atrial natriuretic hormone (ANH) and the Na+/K+ pump inhibitor) digitalis-like substance (DLS), and their relation to hypertension, 28 patients with pituitary- or adrenal-dependent Cushing's syndrome and six patients on high-dose prednisone treatment were studied. Plasma ANH levels were increased in patients with Cushing's syndrome (36.0 +/- 1.4 (S.E.M.) ng/l) compared with those in healthy controls (28.6 +/- 1.3 ng/l, P less than 0.01). In prednisone-treated patients, ANH levels (43.8 +/- 4.5 ng/l) were higher than those in patients with Cushing's syndrome and in controls (P less than 0.05 and P less than 0.01 respectively). DLS measured by radioimmunoassay and binding of [3H]ouabain to erythrocytes was not altered in patients with hypercortisolaemia. Slightly decreased DLS activity in the erythrocyte 86Rb uptake inhibition assay was found in patients with Cushing's syndrome (52.9 +/- 2.7%) compared with that in controls (60.9 +/- 1.8%, P less than 0.02). With the exception of cortisol (r = 0.52, P less than 0.01), none of the other factors determined correlated with the mean arterial pressure in patients with Cushing's syndrome. Thus, a chronic excess of endogenous and exogenous glucocorticoids increases plasma levels of ANH, but does not substantially influence DLS activity or plasma levels. Neither natriuretic factor is directly related to hypertension in Cushing's syndrome.
为了研究慢性高皮质醇血症对内源性利钠因子（心房利钠激素（ANH）和钠/钾泵抑制剂）洋地黄样物质（DLS）的影响及其与高血压的关系，对28例垂体或肾上腺依赖性库欣综合征患者和6例接受大剂量泼尼松治疗的患者进行了研究。与健康对照组（28.6±1.3 ng/l，P<0.01）相比，库欣综合征患者的血浆ANH水平升高（36.0±1.4（标准误）ng/l）。在接受泼尼松治疗的患者中，ANH水平（43.8±4.5 ng/l）高于库欣综合征患者和对照组（分别为P<0.05和P<0.01）。通过放射免疫测定法测量的DLS以及[3H]哇巴因与红细胞的结合在高皮质醇血症患者中未发生改变。在红细胞86Rb摄取抑制试验中，发现库欣综合征患者的DLS活性略有降低（52.9±2.7%），而对照组为（60.9±1.8%，P<0.02）。除皮质醇外（r=0.52，P<0.01），库欣综合征患者中测定的其他因素均与平均动脉压无关。因此，内源性和外源性糖皮质激素的长期过量会增加血浆ANH水平，但对DLS活性或血浆水平没有实质性影响。在库欣综合征中，这两种利钠因子均与高血压无直接关系。
