Brown W A, Keitner G, Qualls C B, Haier R
Arch Gen Psychiatry. 1985 Feb;42(2):121-3. doi: 10.1001/archpsyc.1985.01790250015001.
The dexamethasone suppression test (DST) as now commonly carried out in psychiatric settings yields "abnormal" results in many conditions including the healthy state. To determine whether the DST accurately identifies patients with physiologically meaningful increases in pituitary-adrenocortical activity, we compared DST results to baseline urinary cortisol level. Thirty-four psychiatric inpatients underwent a 24-hour urine collection and then a DST using 1 or 2 mg of dexamethasone. With the common 1-mg DST, 24-hour urinary cortisol levels in nonsuppressors and suppressors did not differ. With the 2-mg DST, however, nonsuppressors had significantly higher urinary cortisol levels than suppressors, and all nonsuppressors had urinary cortisol levels above the normal range. Thus, the 1-mg DST may not identify the heuristically important subgroup of psychiatric patients who have a pathophysiologically meaningful alteration in pituitary-adrenal regulation.
目前在精神科环境中普遍进行的地塞米松抑制试验（DST）在包括健康状态在内的许多情况下都会产生“异常”结果。为了确定DST是否能准确识别垂体 - 肾上腺皮质活动生理上有意义增加的患者，我们将DST结果与基线尿皮质醇水平进行了比较。34名精神科住院患者进行了24小时尿液收集，然后使用1或2毫克地塞米松进行DST。采用常见的1毫克DST时，未抑制者和抑制者的24小时尿皮质醇水平没有差异。然而，采用2毫克DST时，未抑制者的尿皮质醇水平明显高于抑制者，并且所有未抑制者的尿皮质醇水平均高于正常范围。因此，1毫克DST可能无法识别垂体 - 肾上腺调节存在病理生理意义改变的精神科患者这一具有启发意义的重要亚组。
