Ng L L, Evans D J, Burke C W
Radcliffe Infirmary, Oxford, UK.
Clin Endocrinol (Oxf). 1988 Feb;28(2):233-41. doi: 10.1111/j.1365-2265.1988.tb03660.x.
Because corticosteroids have important effects on sodium homeostasis, we studied leucocyte 22Na efflux in patients with Cushing's syndrome. The ouabain-sensitive 22Na+ efflux rate constant was raised in Cushing's syndrome (mean +/- SD 2.84 +/- 0.32 vs 2.35 +/- 0.53/h, P less than 0.001, n = 15). This efflux rate constant correlated with the urinary free cortisol (rs = 0.61, P less than 0.02), but less significantly with the 0900 h plasma cortisol (rs = 0.46, P less than 0.08). There was no correlation with the supine plasma aldosterone. Intracellular sodium content was significantly lower in Cushing's syndrome (21.1 +/- 4.6 vs 27.8 +/- 9.5 mmol/kg dry weight, P less than 0.01), with a raised intracellular potassium to sodium content ratio (16.1 +/- 3.3 vs 12.9 +/- 3.6, P less than 0.01). After treatment of the Cushing's syndrome by trans-sphenoidal adenomectomy or adrenalectomy, these defects in cellular sodium balance were corrected. Thus, the distribution of sodium between intra- and extracellular fluid may be affected by adrenal corticosteroids via an action on the sodium pump.
由于皮质类固醇对钠稳态有重要影响，我们研究了库欣综合征患者白细胞的22Na外排情况。库欣综合征患者哇巴因敏感的22Na+外排速率常数升高（平均值±标准差为2.84±0.32/h，而对照组为2.35±0.53/h，P<0.001，n=15）。该外排速率常数与尿游离皮质醇相关（rs=0.61，P<0.02），但与上午9点血浆皮质醇的相关性较弱（rs=0.46，P<0.08）。与仰卧位血浆醛固酮无相关性。库欣综合征患者细胞内钠含量显著降低（21.1±4.6与27.8±9.5 mmol/kg干重，P<0.01），细胞内钾钠含量比升高（16.1±3.3与12.9±3.6，P<0.01）。经蝶窦腺瘤切除术或肾上腺切除术治疗库欣综合征后，细胞钠平衡的这些缺陷得到纠正。因此，肾上腺皮质类固醇可能通过对钠泵的作用影响细胞内外液之间的钠分布。
