Loli P, Berselli M E, Frascatani F, Muratori F, Tagliaferri M
J Endocrinol Invest. 1984 Apr;7(2):93-6. doi: 10.1007/BF03348396.
The effect of an oral dose of 200 or 400 mg sodium valproate (DPA) on ACTH and cortisol secretion was assessed in 11 patients with Cushing's disease (3 bilaterally adrenalectomized), 3 patients with Nelson's syndrome and 6 patients with Addison's disease. In none of the patients examined DPA induced changes in ACTH (and cortisol) levels appreciably different from the fluctuations recorded after placebo administration. The effect of a long term administration of sodium valproate (600-1000 mg/day) was evaluated in 2 patients with active Cushing's disease and in 1 patient with Nelson's syndrome (3 weeks, 3, 9 months respectively); in the 2 patients with Cushing's disease ACTH and cortisol secretion, 17-hydroxy-corticosteroids (17-OHCS) urinary excretion did not change during DPA treatment. Similarly the cortisol response to hypoglycemia and the 17-OHCS urinary excretion after dexamethasone were not normalized. Long term DPA administration did not induce either clinical or hormonal modifications in the patient with Nelson's syndrome. These findings do not support the possibility that a deficiency of a GABAergic system plays a role in the pathogenesis of ACTH hypersecretion. DPA does not seem to be of therapeutical value in the medical management of Cushing's disease and Nelson's syndrome.
对11例库欣病患者（3例双侧肾上腺切除）、3例纳尔逊综合征患者和6例艾迪生病患者评估了口服200或400毫克丙戊酸钠（DPA）对促肾上腺皮质激素（ACTH）和皮质醇分泌的影响。在所检查的患者中，没有一例DPA引起的ACTH（和皮质醇）水平变化明显不同于给予安慰剂后记录的波动。对2例活动性库欣病患者和1例纳尔逊综合征患者（分别为3周、3个月和9个月）评估了长期服用丙戊酸钠（600 - 1000毫克/天）的效果；在2例库欣病患者中，DPA治疗期间ACTH和皮质醇分泌、17 - 羟皮质类固醇（17 - OHCS）尿排泄未发生变化。同样，对低血糖的皮质醇反应和地塞米松后的17 - OHCS尿排泄也未恢复正常。长期给予DPA未引起纳尔逊综合征患者的临床或激素改变。这些发现不支持γ-氨基丁酸能系统缺陷在促肾上腺皮质激素分泌过多的发病机制中起作用的可能性。DPA在库欣病和纳尔逊综合征的药物治疗中似乎没有治疗价值。
