Iankelevich D E, Tsarikovskaia N G, Tkach F S, Nikolaeva V M, Langova N A
Probl Endokrinol (Mosk). 1978 May-Jun;24(3):22-7.
In patients with thyrotoxicosis combined with primary affection of the central nervous system (CNS)-encephalitis, diencephalitis-there was revealed, like in common thyrotoxicosis, an increased production by the adrenal cortex of hydrocortisone, its intensified transformation and inactivation, reduced production of 17-ketosteroid chiefly due to the fall of dehydroepiandrosterone content, an increased urinary excretion of adrenaline and a decreased-of noradrenaline. The use of functional test with the ACTH administration demonstrated organic affection of the CNS to sharply aggravate the weakening and even the exhaustion of the functional reserves of the glomerular and the reticular zones of the adrenal cortex developing during thyrotoxicosis, and also the reserve possibilities of the sympathico-adrenal system. Direction of the changes in the 24-hour excretion of 17-OCS and corticosteriods was the same in the majority of cases. The latter can point to the presence of functional association between the hypothalamus-hypophysis-adrenal cortex systems and adrenergic regulation in these patients.
在甲状腺毒症合并中枢神经系统(CNS)原发性病变——脑炎、间脑炎的患者中,与普通甲状腺毒症一样,发现肾上腺皮质氢化可的松的生成增加,其转化和失活增强,17-酮类固醇生成减少,主要是由于脱氢表雄酮含量下降,肾上腺素尿排泄增加,去甲肾上腺素尿排泄减少。给予促肾上腺皮质激素(ACTH)进行功能试验表明,CNS的器质性病变会急剧加重甲状腺毒症期间肾上腺皮质肾小球区和网状区功能储备的减弱甚至耗竭,以及交感-肾上腺系统的储备能力。在大多数情况下,17-氧皮质类固醇(17-OCS)和皮质类固醇24小时排泄的变化方向相同。这可能表明这些患者下丘脑-垂体-肾上腺皮质系统与肾上腺素能调节之间存在功能关联。