Dolman L I, Nolan G, Jubiz W
JAMA. 1979 Mar 23;241(12):1251-3.
Basal plasma adrenocorticotrophic hormone (ACTH) and cortisol concentrations as well as plasma ACTH and 11-deoxycortisol responses to the administration of a single dose of metyrapone were evaluated in 104 patients with intact pituitary-adrenal axis, in 20 patients with secondary adrenal insufficiency, and in seven patients with primary adrenal insufficiency. In patients with primary adrenal insufficiency, baseline ACTH levels were high. Following metyrapone administration, 11-deoxycortisol concentrations were low and ACTH levels did not change. In patients with secondary adrenal insufficiency, baseline plasma ACTH levels were normal, but neither 11-deoxycortisol nor ACTH levels increased in response to metyrapone. The metyrapone test is not only useful to screen for adrenal insufficiency, it is also useful to differentiate a primary from a secondary cause.
在104例垂体-肾上腺轴功能正常的患者、20例继发性肾上腺功能不全患者和7例原发性肾上腺功能不全患者中，评估了基础血浆促肾上腺皮质激素（ACTH）和皮质醇浓度，以及单次服用甲吡酮后血浆ACTH和11-脱氧皮质醇的反应。在原发性肾上腺功能不全患者中，基础ACTH水平较高。服用甲吡酮后，11-脱氧皮质醇浓度较低，ACTH水平未发生变化。在继发性肾上腺功能不全患者中，基础血浆ACTH水平正常，但服用甲吡酮后11-脱氧皮质醇和ACTH水平均未升高。甲吡酮试验不仅有助于筛查肾上腺功能不全，还有助于区分原发性和继发性病因。
