Daly J R, Fletcher M R, Glass D, Chambers D J, Bitensky L, Chayen J
Br Med J. 1974 Jun 8;2(5918):521-4. doi: 10.1136/bmj.2.5918.521.
The development of the highly sensitive cytochemical bioassay for ACTH has permitted the measurement of plasma ACTH levels during the insulin hypoglycaemia test (I.H.T.) in patients treated with corticosteroids and corticotrophin. The ACTH, corticosteroid, and growth hormone (GH) responses in the I.H.T. were measured in three groups of 12 rheumatoid arthritis patients. One group was receiving long-term corticotrophin treatment, the second was undergoing long-term corticosteroid treatment, and the third had never received systemic hormone therapy. The increments in plasma ACTH, corticosteroids, and GH were diminished in the corticosteroid-treated group, as were increments in plasma GH and ACTH in the corticotrophin-treated group; but in this group the corticosteroid increment was normal. Examination of the area under the curve of the ACTH response showed that the total amount of ACTH secreted was normal though the rate of secretion was reduced. In the corticosteroid-treated group both rate and total secretion were diminished.
促肾上腺皮质激素（ACTH）高敏细胞化学生物测定法的发展，使得在接受皮质类固醇和促肾上腺皮质激素治疗的患者进行胰岛素低血糖试验（I.H.T.）期间能够测量血浆ACTH水平。在三组每组12名类风湿性关节炎患者中测量了I.H.T.中的ACTH、皮质类固醇和生长激素（GH）反应。一组接受长期促肾上腺皮质激素治疗，第二组接受长期皮质类固醇治疗，第三组从未接受过全身激素治疗。皮质类固醇治疗组血浆ACTH、皮质类固醇和GH的增量减少，促肾上腺皮质激素治疗组血浆GH和ACTH的增量也减少；但在该组中皮质类固醇增量正常。对ACTH反应曲线下面积的检查表明，尽管分泌速率降低，但分泌的ACTH总量正常。在皮质类固醇治疗组中，速率和总分泌量均降低。
