Malik K J, Wakelin K, Dean S, Cove D H, Wood P J
Department of Medicine, Weymouth & District Hospital, UK.
Ann Clin Biochem. 1996 May;33 ( Pt 3):187-9. doi: 10.1177/000456329603300302.
The referral of a patient with features of Cushing's syndrome but with suppressed plasma cortisol and adrenocorticotrophic hormone concentrations prompted us to study the effect of medroxyprogesterone acetate (MPA) therapy on the adrenal axis. 11 women (aged 54-82 years) who were receiving 200-400 mg/day MPA were studied. Of these, four had subnormal plasma cortisol responses to a short synacthen test, and two more had borderline responses (30 min post-synacthen plasma cortisol results of 411 and 511 nmol/L). We conclude that suppression of the adrenal axis occurs relatively frequently in patients on MPA and that such patients should be checked for evidence of suppression before MPA therapy is withdrawn.
一名患有库欣综合征特征但血浆皮质醇和促肾上腺皮质激素浓度受到抑制的患者的转诊促使我们研究醋酸甲羟孕酮（MPA）治疗对肾上腺轴的影响。我们对11名正在接受每日200 - 400毫克MPA治疗的女性（年龄在54 - 82岁之间）进行了研究。其中，4名患者对短程促肾上腺皮质激素试验的血浆皮质醇反应低于正常水平，另外2名患者的反应处于临界值（促肾上腺皮质激素注射后30分钟血浆皮质醇结果分别为411和511纳摩尔/升）。我们得出结论，接受MPA治疗的患者中肾上腺轴抑制相对频繁发生，并且在停用MPA治疗之前，应对此类患者检查是否有抑制的证据。
