晨间皮质醇作为诊断原发性肾上腺皮质功能减退症的短程Synacthen试验替代方法。
Morning cortisol as an alternative to Short Synecthan test for the diagnosis of primary adrenal insufficiency.
作者信息
Ulhaq Imran, Ahmad Tauseef, Khoja Adeel, Islam Najmul
机构信息
Dr. Imran Ulhaq, FCPS. Consultant Endocrinologist Aga Khan University Hospital, Karachi, Pakistan.
Dr. Tauseef Ahmad, FCPS. Assistant Professor of Medicine/Endocrinology, Dr. Ziauddin University Hospital, Karachi, Pakistan.
出版信息
Pak J Med Sci. 2019 Sep-Oct;35(5):1413-1416. doi: 10.12669/pjms.35.5.1208.
OBJECTIVE
To determine 7-9 am serum cortisol less than 5mcg/dl is an independent reliable confirmatory test for the diagnosis of primary adrenal insufficiency (PAI).
METHODS
A total of 164 patients who visited the outpatient or inpatient department of Aga Khan University Hospital from June 2011 to June 2017 were included for the study. All those patients whose levels came out less than 5mcg/dl were recruited for the study and they all underwent SST. Other demographic and laboratory data were also recorded.
RESULTS
The sensitivity of morning cortisol for diagnosis of PAI is 100% if levels are <1mcg/dl and decreases to 71.88% if levels are up to 5mcg/dl.
CONCLUSION
Morning cortisol is sensitive enough as an alternative to SST if levels are <1mcg/dl (100%). However, if the levels are increased from > 1mcg/dl to < 5 mcg/dl, the sensitivity decreases gradually from 98% to 71%.
目的
确定上午7 - 9点血清皮质醇低于5微克/分升是否是诊断原发性肾上腺皮质功能减退症（PAI）的一项独立可靠的确诊试验。
方法
纳入2011年6月至2017年6月期间在阿迦汗大学医院门诊或住院部就诊的164例患者进行研究。所有皮质醇水平低于5微克/分升的患者被纳入研究，他们均接受了促肾上腺皮质激素刺激试验（SST）。还记录了其他人口统计学和实验室数据。
结果
如果上午皮质醇水平<1微克/分升，其诊断PAI的敏感性为100%；如果水平高达5微克/分升，敏感性则降至71.88%。
结论
如果上午皮质醇水平<1微克/分升（敏感性为100%），作为促肾上腺皮质激素刺激试验的替代方法，其敏感性足够高。然而，如果水平从>1微克/分升升高至<5微克/分升，敏感性则从98%逐渐降至71%。
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