Oberger E, Thorén M, Engström I
Acta Paediatr Scand. 1986 Jan;75(1):164-71. doi: 10.1111/j.1651-2227.1986.tb10175.x.
Hypothalamic-pituitary-adrenal (HPA) function was studied in 23 children with severe bronchial asthma during and after long-term treatment with prednisolone and/or ACTH1-24 depot tetracosactrin) by means of ACTH stimulation test and insulin tolerance test. In the 14 children primarily treated with depot tetracosactrin, the cortisol levels in insulin tests were within normal limits both during and after treatment. An enhanced response to ACTH stimulation was found during the treatment period. During treatment with prednisolone a marked impairment of the adrenocortical function was found, with low basal plasma cortisol levels and subnormal response to ACTH stimulation, more marked the lower the age at the start of treatment and the higher the dose per kg body weight. After substitution with depot tetracosactrin the HPA-function was restituted, with plasma cortisol levels within normal limits. Growth hormone levels after insulin induced hypoglycemia were greater than or equal to 7 ng/ml during and after treatment with depot tetracosactrin. As long-term treatment with depot tetracosactrin has little side-effects in terms of suppression of the HPA-axis it is a useful alternative to oral prednisolone in severe asthma in children.
通过促肾上腺皮质激素（ACTH）刺激试验和胰岛素耐量试验，对23例患有严重支气管哮喘的儿童在长期使用泼尼松龙和/或长效促肾上腺皮质激素（ACTH1-24，替可克肽）治疗期间及治疗后下丘脑-垂体-肾上腺（HPA）功能进行了研究。在14例主要接受长效促肾上腺皮质激素治疗的儿童中，胰岛素试验中的皮质醇水平在治疗期间及治疗后均在正常范围内。在治疗期间发现对ACTH刺激的反应增强。在使用泼尼松龙治疗期间，发现肾上腺皮质功能明显受损，基础血浆皮质醇水平较低，对ACTH刺激的反应低于正常水平，治疗开始时年龄越小、每公斤体重剂量越高，这种情况越明显。在用长效促肾上腺皮质激素替代后，HPA功能恢复，血浆皮质醇水平在正常范围内。在用长效促肾上腺皮质激素治疗期间及治疗后，胰岛素诱导低血糖后的生长激素水平大于或等于7 ng/ml。由于长效促肾上腺皮质激素的长期治疗对HPA轴的抑制作用副作用较小，因此它是儿童重度哮喘中口服泼尼松龙的一种有用替代药物。
