利福平与异烟肼治疗对库欣综合征基础检查的影响。

The effects of therapy with rifampicin and isoniazid on basic investigations for Cushing's syndrome.

作者信息

Zawawi T H, al-Hadramy M S, Abdelwahab S M

机构信息

Department of Medicine, King Abdulaziz University Hospital, Jeddah, Saudi Arabia.

出版信息

Ir J Med Sci. 1996 Oct-Dec;165(4):300-2. doi: 10.1007/BF02943098.

DOI:10.1007/BF02943098

PMID:8990663

Abstract

Rifampicin(R) is a potent enzyme inducer which is now widely used to treat many conditions. We have investigated its effect on adrenal function tests in 18 adults with tuberculosis on rifampicin (R) and isoniazid (INH) as in-patients. Midnight cortisol was above 250 nmol/l in 11 patients with a mean +/- (SD) of 340 +/- 193 nmol/l. The morning serum cortisol following 1 and 4 mg dexamethasone overnight was abnormal in 88.9 per cent and 83.3 per cent respectively. The respective mean values +/- (SD) were 350 +/- 179 and 336 +/- 279 nmol/l. The mean 24-hour urinary free cortisol +/- SD was 513 +/- 375 nmol and was above normal in 6 (33.3 per cent) patients. These results show that midnight cortisol, dexamethasone suppression tests and 24-hour urinary free cortisol are misleading in patients with tuberculosis on (R) and should not be employed for investigating such patients for Cushing's syndrome.

摘要

利福平（R）是一种强效的酶诱导剂，目前广泛用于治疗多种病症。我们对18例住院接受利福平（R）和异烟肼（INH）治疗的成年结核病患者的肾上腺功能测试进行了研究。11例患者的午夜皮质醇高于250 nmol/l，平均±（标准差）为340±193 nmol/l。过夜给予1毫克和4毫克地塞米松后，次日上午血清皮质醇分别有88.9%和83.3%异常。各自的平均值±（标准差）分别为350±179和336±279 nmol/l。24小时尿游离皮质醇的平均±标准差为513±375 nmol，6例（33.3%）患者高于正常水平。这些结果表明，对于接受（R）治疗的结核病患者，午夜皮质醇、地塞米松抑制试验和24小时尿游离皮质醇会产生误导，不应将其用于此类患者库欣综合征的检查。