Sandman C A, Barron J L, Parker L
Pharmacol Biochem Behav. 1985 Jul;23(1):21-6. doi: 10.1016/0091-3057(85)90124-8.
Previous reports of cognitive and social improvement in the mentally retarded after administration of MSH/ACTH fragments suggested disregulation of the hypothalamic-pituitary-adrenal (HPA) axis. The current study examined the integrity of this system with the Dexamethasone Suppression Test (DST). The DST is a biological index of HPA integrity and recently has been used as a diagnostic aid for endogenous depression. Thirty-five mentally retarded patients were administered 1 mg of dexamethasone just after a sample of blood was taken. Blood samples were analyzed for cortisol by RIA at 11:00 p.m. (basal), 8:00 a.m., 4:00 p.m., and 10:00 p.m. Between 40% and 48% (depending on sampling) of the patients failed to suppress cortisol (greater than 4 micrograms/dl), after the DST challenge. The results suggested that a significant proportion of mentally retarded patients have a DST index reflecting a disordered HPA axis and complements earlier studies of cognitive enhancement observed after treatment with MSH/ACTH fragments. The possibility that the stress of hospitalization was related to a disordered HPA was suggested. The possible co-existence of depression in the mentally retarded invites further study.
先前关于给智障患者施用促黑素/促肾上腺皮质激素片段后认知和社交能力改善的报告表明，下丘脑 - 垂体 - 肾上腺（HPA）轴调节紊乱。本研究通过地塞米松抑制试验（DST）检测了该系统的完整性。DST是HPA完整性的生物学指标，最近已被用作内源性抑郁症的诊断辅助手段。35名智障患者在采集血样后立即服用1毫克地塞米松。通过放射免疫分析（RIA）在晚上11点（基础值）、上午8点、下午4点和晚上10点对血样进行皮质醇分析。在DST激发后，40%至48%（取决于采样时间）的患者未能抑制皮质醇（大于4微克/分升）。结果表明，相当一部分智障患者的DST指数反映了HPA轴紊乱，这补充了早期关于用促黑素/促肾上腺皮质激素片段治疗后观察到认知增强的研究。有人提出住院压力可能与HPA紊乱有关。智障患者中可能并存抑郁症，这有待进一步研究。
