Reder A T, Lowy M T, Meltzer H Y, Antel J P
Neurology. 1987 May;37(5):849-53. doi: 10.1212/wnl.37.5.849.
We studied the 1-mg overnight dexamethasone suppression test (DST) in patients with MS. In about 50% of patients, serum cortisol did not fall below 5.0 micrograms/dl. This percentage was similar in patients with major depression, but contrasted to 11% in normal controls. MS nonsuppressors were not more depressed than suppressors; dexamethasone bioavailability may have contributed because nonsuppressors had lower serum dexamethasone levels than suppressors. Suppressors improved in the week following ACTH therapy; nonsuppressors did not. Furthermore, serum dexamethasone values correlated positively with clinical response to ACTH treatment. The DST may be a useful neuroendocrine test of glucocorticoid sensitivity in MS patients.
我们对患有多发性硬化症（MS）的患者进行了1毫克过夜地塞米松抑制试验（DST）。在大约50%的患者中，血清皮质醇水平未降至5.0微克/分升以下。这一比例在重度抑郁症患者中相似，但与正常对照组的11%形成对比。MS不抑制者并不比抑制者更抑郁；地塞米松的生物利用度可能起了作用，因为不抑制者的血清地塞米松水平低于抑制者。抑制者在促肾上腺皮质激素（ACTH）治疗后的一周内病情有所改善；不抑制者则没有。此外，血清地塞米松值与对ACTH治疗的临床反应呈正相关。DST可能是一种用于检测MS患者糖皮质激素敏感性的有用的神经内分泌试验。
