Deck K A, Baur P, Hillen H
Acta Endocrinol (Copenh). 1979 May;91(1):122-33. doi: 10.1530/acta.0.0910122.
Plasma cortisol levels in 2 normal persons, 2 obese persons, 2 uraemic patients, and 2 patients with cirrhosis of the liver were raised in 4 steps by a combination of iv priming doses and continuous infusions of cortisol. Plasma cortisol levels and transcortin binding were measured as well as plasma clearance rates of labelled and unlabelled cortisol during each of the 5 experimental periods. Plasma cortisol levels increased less and plasma clearance rates of labelled and unlabelled cortisol increased more in obese persons than in normal persons; in patients with disturbed metabolism of cortisol (uraemia, cirrhosis of the liver) the reverse is true. Plasma clearance rates of free cortisol were calculated and differed from an estimated hepatic plasma flow of 0.7 1/min under certain conditions. Since free cortisol is metabolized faster than transcortin-bound cortisol, increasing plasma clearance rates of cortisol are probably due to increasing ratios free/bound cortisol when total plasma cortisol levels are raised. Low plasma clearance rates of cortisol in uraemia and cirrhosis of the liver are thought to be due to endproduct inhibition, respectively reduced liver cell mass.
通过静脉注射首剂剂量和持续输注皮质醇相结合的方式，分4个步骤提高了2名正常人、2名肥胖者、2名尿毒症患者和2名肝硬化患者的血浆皮质醇水平。在5个实验阶段的每个阶段，均测量了血浆皮质醇水平、皮质素结合情况以及标记和未标记皮质醇的血浆清除率。与正常人相比，肥胖者的血浆皮质醇水平升高较少，而标记和未标记皮质醇的血浆清除率升高较多；在皮质醇代谢紊乱的患者（尿毒症、肝硬化）中，情况则相反。计算了游离皮质醇的血浆清除率，在某些情况下，其与估计的肝血浆流量0.7升/分钟有所不同。由于游离皮质醇的代谢速度比与皮质素结合的皮质醇快，当血浆总皮质醇水平升高时，皮质醇血浆清除率的增加可能是由于游离/结合皮质醇的比例增加所致。尿毒症和肝硬化患者中皮质醇的低血浆清除率分别被认为是由于终产物抑制和肝细胞数量减少。
