Yoshida K, Satowa H, Sato A, Ichikawa Y, Kream J, Levin J, Zumoff B, Hellman L, Fukushima D K
Acta Endocrinol (Copenh). 1979 Jun;91(2):319-28. doi: 10.1530/acta.0.0910319.
Plasma cortisol profiles were studied by the frequent sampling method in 5 patients with Cushing's disease (CD), 7 patients with Cushing's syndrome due to adrenocortical adenoma (AA), and one patient with bronchogenic carcinoma. Plasma ACTH was measured by radioimmunoassay at 10 min intervals in 2 of the subjects. In CD, there was distinct episodic secretion of cortisol and ACTH; the coefficients of variation about the mean plasma cortisol concentration ranged from 24 to 27%; plasma ACTH ranged from zero to 455 pg/ml with a mean of 94 pg/ml. In AA, the tumour secreted cortisol at a constant rate with little fluctuation; the coefficients of variation of plasma cortisol concentration ranged from 8 to 14%; plasma concentrations of ACTH were always near zero. In the patient with bronchogenic carcinoma, the coefficient of variation of cortisol was 14%. These results were apparent even in profiles of plasma cortisol concentrations measured over only a 6 h period. It is concluded that characteristics of plasma cortisol and ACTH secretory patterns are helpful in differentiating Cushing's syndrome of differing aetiology.
采用频繁采样法对5例库欣病（CD）患者、7例肾上腺皮质腺瘤（AA）所致库欣综合征患者及1例支气管肺癌患者的血浆皮质醇水平进行了研究。对其中2例受试者每隔10分钟通过放射免疫分析法测定血浆促肾上腺皮质激素（ACTH）。在库欣病患者中，皮质醇和ACTH有明显的间歇性分泌；血浆皮质醇浓度均值的变异系数在24%至27%之间；血浆ACTH浓度在0至455 pg/ml之间，均值为94 pg/ml。在肾上腺皮质腺瘤患者中，肿瘤以恒定速率分泌皮质醇，波动很小；血浆皮质醇浓度的变异系数在8%至14%之间；血浆ACTH浓度始终接近零。在支气管肺癌患者中，皮质醇的变异系数为14%。即使仅在6小时内测定的血浆皮质醇浓度曲线中，这些结果也很明显。结论是血浆皮质醇和ACTH分泌模式的特征有助于鉴别不同病因的库欣综合征。
