Kehlet H, Binder C
Br Med J. 1973 Apr 21;2(5859):147-9. doi: 10.1136/bmj.2.5859.147.
Forty-eight patients receiving glucocorticoid treatment were tested with ACTH stimulation using alpha(1, 24) ACTH (tetracosactrin). All patients subsequently underwent non-acute major surgery without any glucocorticoid administration, and their clinical course and plasma corticosteroids were followed closely. No case of adrenocortical insufficiency was observed. A highly significant correlation was found between the pre-operative adrenocortical response to ACTH and the hypothalmic-pituitary-adrenocortical (H.P.A.) response to surgery. A normal response to ACTH stimulation was never followed by a greatly impaired H.P.A. response to surgery. It seems that a simple ACTH stimulation test is reliable in predicting the integrated H.P.A. response to major stress in glucocorticoid-treated patients.
对48例接受糖皮质激素治疗的患者使用α（1, 24）促肾上腺皮质激素（二十四肽促皮质素）进行促肾上腺皮质激素刺激试验。随后，所有患者均未接受任何糖皮质激素给药而进行了非急性大手术，并密切观察其临床病程和血浆皮质类固醇水平。未观察到肾上腺皮质功能不全的病例。术前促肾上腺皮质激素刺激试验的肾上腺皮质反应与下丘脑 - 垂体 - 肾上腺皮质（H.P.A.）对手术的反应之间存在高度显著的相关性。对促肾上腺皮质激素刺激试验反应正常的患者，其H.P.A.对手术的反应从未出现严重受损的情况。看来，简单的促肾上腺皮质激素刺激试验在预测糖皮质激素治疗患者对重大应激的综合H.P.A.反应方面是可靠的。
