Matsuki M, Nishida S, Horino M, Tenku A, Oyama H
Acta Endocrinol (Copenh). 1982 Sep;101(1):62-5. doi: 10.1530/acta.0.1010062.
A single dose methyrapone test (MTP test) was carried out on 6 normal men by administering 1.0 g of metyrapone at 08.00-09.00 h with and without dexamethasone (DXM-MTP test) pre-treatment. Plasma 11-deoxycortisol, pregnenolone, ACTH and cortisol were measured before administration of the drug, and at hourly intervals for 6 h. In the MTP test, 11-deoxycortisol increased significantly at 1 h with a peak at 5 h, whereas significant increases in pregnenolone and ACTH were not seen until 3 h. There was a definite decrease in the cortisol level at 1 h with the lowest level measured at 2 h. Thus, a time discrepancy between plasma 11-deoxycortisol and ACTH concentrations was observed. The increase in 11-deoxycortisol after metyrapone should be divided into two phases: the increase in phase II (after 3 h) is due to the pituitary ACTH reserve, and that in phase I (the first 2 h) is due to some mechanism other than the pituitary ACTH reserve. The increased amount of 11-dexoycortisol in phase II (218.1 nmol) occupied 60.5% of the total increased amount in phases I and II (360.6 nmol). The cortisol/(cortisol + 11-deoxycortisol) ratio reached its lowest point 3 h after metyrapone treatment. This might be due to the initiation of an additional surge in 11-deoxycortisol by the ACTH reserve at 3 h.
对6名正常男性进行了单剂量甲吡酮试验（MTP试验），在上午8点至9点给予1.0 g甲吡酮，同时进行和不进行地塞米松（DXM-MTP试验）预处理。在给药前以及给药后每小时测量一次血浆11-脱氧皮质醇、孕烯醇酮、促肾上腺皮质激素（ACTH）和皮质醇，持续6小时。在MTP试验中，11-脱氧皮质醇在1小时时显著增加，在5小时时达到峰值，而孕烯醇酮和ACTH直到3小时才出现显著增加。皮质醇水平在1小时时明显下降，在2小时时测得最低水平。因此，观察到血浆11-脱氧皮质醇和ACTH浓度之间存在时间差异。甲吡酮后11-脱氧皮质醇的增加应分为两个阶段：第二阶段（3小时后）的增加是由于垂体ACTH储备，而第一阶段（前2小时）的增加是由于垂体ACTH储备以外的某种机制。第二阶段11-脱氧皮质醇增加量（218.1 nmol）占第一阶段和第二阶段总增加量（360.6 nmol）的60.5%。甲吡酮治疗后3小时，皮质醇/（皮质醇+11-脱氧皮质醇）比值达到最低点。这可能是由于3小时时ACTH储备引发了11-脱氧皮质醇的额外激增。
