Tucci J R, Nowakowski K J, Jackson I M
Roger Williams General Hospital, Division of Endocrinology and Metabolism, Providence, Rhode Island 02908.
J Endocrinol Invest. 1989 Mar;12(3):197-200. doi: 10.1007/BF03349961.
Cyproheptadine has been reported to effect remissions in up to 50% of patients with Cushing's disease presumably at a hypothalamic level. Endocrine studies including CRF testing were performed in a 37-year-old woman with Cushing's disease. Cyproheptadine therapy resulted in a clinical and chemical remission. During therapy, basal plasma and urinary steroid levels were normal as were responses to dexamethasone, metyrapone, and insulin induced hypoglycemia. CRF administration in the untreated patient resulted in a markedly exaggerated increase in plasma ACTH and cortisol levels, while with cyproheptadine therapy responses were considerably blunted but still greater than normal. These observations are the first to provide evidence supporting a pituitary effect of cyproheptadine in Cushing's disease in vivo and raise questions regarding the assumption of hypothalamic dysfunction in those patients with Cushing's disease responding to cyproheptadine.
据报道，赛庚啶可使高达50%的库欣病患者病情缓解，可能是通过下丘脑水平起作用。对一名37岁的库欣病女性患者进行了包括促肾上腺皮质激素释放因子（CRF）检测在内的内分泌研究。赛庚啶治疗导致了临床和生化缓解。治疗期间，基础血浆和尿类固醇水平正常，对地塞米松、甲吡酮和胰岛素诱导的低血糖的反应也正常。未治疗的患者注射CRF后，血浆促肾上腺皮质激素（ACTH）和皮质醇水平显著过度升高，而在赛庚啶治疗期间，反应明显减弱，但仍高于正常水平。这些观察结果首次提供了证据，支持赛庚啶在体内对库欣病患者垂体的作用，并对那些对赛庚啶有反应的库欣病患者下丘脑功能障碍的假设提出了质疑。
