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[联合治疗对伊钦科-库欣病下丘脑-垂体系统激素分泌动力学的影响]

[Dynamics of secretion of hypothalamo-hypophyseal system hormones in Itsenko-Cushing disease as affected by combination therapy].

作者信息

Slavnov V N, Valueva G V, Luchitskiĭ E V, Komissarenko I V, Cheban A K

出版信息

Probl Endokrinol (Mosk). 1983 Nov-Dec;29(6):28-32.

PMID:6140677
Abstract

The results are presented of the studies on corticotropin, cortisol, beta-lipotropin, beta-endorphine, somatotropin, somatostatin, prolactin and thyrotropin secretion in 46 patients with active Icenko-Cushing's disease at the nearest and late periods after the treatment with an antiserotonin drug--cyproheptadine (peritol) combined with an adrenocortical secretion inhibitor--khloditan. The hormone basal levels and secretion under the action of stress, induced by insulin hypoglycemia or thyroliberin injection, were determined in the patients under examination by radioimmunoassay. In patients with an acute stage of the disease the blood beta-lipotropin, beta-endorphine, corticotropin, cortisol, somatostatin and prolactin concentrations are elevated, whereas those of somatotropin and thyrotropin are lowered. The hypothalamic, hypophyseal and adrenocortical response to stress or thyroliberin injection is reduced. THe combined treatment with khloditan and high doses of cyproheptadine led to pronounced clinical and hormonal remission in 55% of the patients. The blood beta-lipotropin, beta-endorphine, corticotropin, cortisol, somatostatin and somatotropin concentrations returned to normal. The blood prolactin and thyrotropin levels, as well as the response to thyroliberin injection remained disordered.

摘要

本文呈现了对46例活动性伊申科-库欣病患者在使用抗血清素药物——赛庚啶(periactin)联合肾上腺皮质分泌抑制剂——氯地孕酮治疗后的近期和远期,促肾上腺皮质激素、皮质醇、β-促脂素、β-内啡肽、生长激素、生长抑素、催乳素和促甲状腺激素分泌的研究结果。通过放射免疫分析法测定了受检患者在胰岛素低血糖或注射促甲状腺素诱导的应激作用下的激素基础水平和分泌情况。处于疾病急性期的患者,其血液中β-促脂素、β-内啡肽、促肾上腺皮质激素、皮质醇、生长抑素和催乳素的浓度升高,而生长激素和促甲状腺激素的浓度降低。下丘脑、垂体和肾上腺皮质对应激或注射促甲状腺素的反应减弱。氯地孕酮与高剂量赛庚啶联合治疗使55%的患者实现了显著的临床和激素缓解。血液中β-促脂素、β-内啡肽、促肾上腺皮质激素、皮质醇、生长抑素和生长激素的浓度恢复正常。血液中催乳素和促甲状腺激素水平以及对促甲状腺素注射的反应仍紊乱。

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