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婴儿期和儿童期血浆中醛固酮、皮质酮、11-脱氧皮质酮、孕酮、17-羟孕酮、皮质醇和可的松的水平。

Plasma levels of aldosterone, corticosterone, 11-deoxycorticosterone, progesterone, 17-hydroxyprogesterone, cortisol, and cortisone during infancy and childhood.

作者信息

Sippell W G, Dörr H G, Bidlingmaier F, Knorr D

出版信息

Pediatr Res. 1980 Jan;14(1):39-46. doi: 10.1203/00006450-198001000-00010.

Abstract

Plasma aldosterone (A), corticosterone (B), deoxycorticosterone (DOC), progesterone (P), 17-hydroxyprogesterone (17-OHP), cortisol (F), and cortisone (E) were measured simultaneously by specific radioimmunoassays in small plasma samples obtained from 174 normal infants and children between 2 hr and 15 yr of age. The significantly elevated neonatal mean levels (ng/ml) of 2.5 (A), 4.1 (DOC), 53.0 (P), and 6.6 (17-OHP) dropped significantly during infancy reaching prepubertal levels between 3 months and 3 yr of age, with a transient, significant DOC increase between 1--7 yr. The glucocorticoids F andB declined significantly from means of 68 and 4.4 to 11.4 and 0.28 ng/ml, respectively, during the first weeks of life, then increased significantly reaching adult levels between 1--3 yr of age. Mean E fell progressively from 74 ng/ml after birth to 10 ng/ml during 1--5 yr (P less than 0.0001), then slightly increased to adult levels. After age 7 yr, P and 17-OHP, in contrast to the other steroids, rose significantly in both boys and girls relative to pubertal development. The observed changes are thought to be due to (1) adaptation of the adrenal neocortex to extrauterine life after disruption of the fetoplacental unit, (2) a physiologic lack of corticosteroid binding globulin (CBG) during infancy due to maturation of hepatic CBG biosynthesis, (3) the functional immaturity of the infant kidney compensated by an increased activity of the renin-angiotensin-aldosterone system, and (4) gradually increasing gonadal secretion of progestins during puberty.

摘要

采用特异性放射免疫分析法,对174例年龄在2小时至15岁之间的正常婴幼儿和儿童采集的少量血浆样本同时进行血浆醛固酮(A)、皮质酮(B)、脱氧皮质酮(DOC)、孕酮(P)、17-羟孕酮(17-OHP)、皮质醇(F)和可的松(E)的检测。新生儿期A、DOC、P和17-OHP的平均水平(ng/ml)显著升高,分别为2.5、4.1、53.0和6.6,在婴儿期显著下降,到3个月至3岁时达到青春期前水平,1至7岁期间DOC有短暂的显著升高。糖皮质激素F和B在出生后第一周分别从平均68和4.4 ng/ml显著下降至11.4和0.28 ng/ml,然后显著升高,在1至3岁时达到成人水平。平均E从出生后的74 ng/ml逐渐下降至1至5岁时的10 ng/ml(P<0.0001),然后略有升高至成人水平。与其他类固醇不同,7岁以后,男孩和女孩的P和17-OHP相对于青春期发育显著升高。观察到的这些变化被认为是由于:(1)胎儿-胎盘单位中断后肾上腺新皮质对宫外生活的适应;(2)由于肝脏CBG生物合成的成熟,婴儿期生理性缺乏皮质类固醇结合球蛋白(CBG);(3)婴儿肾脏功能不成熟,通过肾素-血管紧张素-醛固酮系统活性增加来代偿;(4)青春期性腺分泌孕激素逐渐增加。

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