Klioua N, Ruget G, Selz F, Cuche J L, Benmiloud M
J Clin Endocrinol Metab. 1987 Jun;64(6):1323-7. doi: 10.1210/jcem-64-6-1323.
The plasma catecholamine response to hypoglycemia was studied in a group of hypopituitary patients with Sheehan's syndrome before (group A) and after (group B) combined cortisol and thyroid hormone treatment as well as in a group of normal women (group C). The mean basal plasma norepinephrine (NE) level was significantly increased in group A compared to levels in groups B and C, in which values were similar. The mean basal plasma epinephrine (E) level was not significantly altered by hypopituitarism. The plasma NE response to hypoglycemia was similar in the three groups, while the plasma E response was blunted in groups A and B. However, the plasma E response was significantly decreased only in half of the patients. The basal E/NE ratio was similar in the three groups, but it was significantly decreased in groups A and B compared to that in group C at the peak. From these data we conclude that 1) hypopituitarism is characterized in the basal state by increased adrenergic tone, probably related to secondary hypothyroidism; and 2) during hypoglycemia adrenal stimulation is impaired only in some patients. The role of ACTH in the regulation of E secretion is minor. Impaired neurogenic regulation in some patients with Sheehan's syndrome could contribute to their illness.
在一组患有席汉综合征的垂体功能减退患者中，研究了低血糖时血浆儿茶酚胺的反应。这组患者分为治疗前的A组、接受皮质醇和甲状腺激素联合治疗后的B组，以及一组正常女性C组。与B组和C组相比，A组的基础血浆去甲肾上腺素（NE）平均水平显著升高，而B组和C组的该值相似。垂体功能减退并未显著改变基础血浆肾上腺素（E）平均水平。三组对低血糖的血浆NE反应相似，而A组和B组的血浆E反应减弱。然而，仅一半患者的血浆E反应显著降低。三组的基础E/NE比值相似，但在峰值时，A组和B组与C组相比显著降低。从这些数据我们得出结论：1）垂体功能减退在基础状态下的特征是肾上腺素能张力增加，可能与继发性甲状腺功能减退有关；2）在低血糖期间，仅部分患者的肾上腺刺激受损。促肾上腺皮质激素（ACTH）在E分泌调节中的作用较小。席汉综合征部分患者神经源性调节受损可能与他们的病情有关。
