Angles J M, Feldman E C, Nelson R W, Feldman M S
Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis 95616-8734, USA.
J Am Vet Med Assoc. 1997 Oct 15;211(8):1002-4.
To evaluate use of urine cortisol-to-creatinine ratio (UC:C) as a means of monitoring response to long-term mitotane treatment in dogs with pituitary-dependent hyperadrenocorticism.
Prospective uncontrolled study.
101 dogs with pituitary-dependent hyperadrenocorticism.
Urine samples were obtained from dogs on the morning an ACTH stimulation test was performed, and owners were asked their opinion on the health of their dog to monitor response to mitotane treatment. Urine was assayed for cortisol and creatinine concentrations, and UC:C was calculated. The UC:C was compared with post-ACTH plasma cortisol concentration.
Post-ACTH plasma cortisol concentration was used to categorize each dog's response to mitotane treatment. The UC:C did not correlate satisfactorily with results of ACTH stimulation testing. Twenty-seven of 85 (32%) dogs would have been incorrectly considered as having received appropriate doses using UC:C. In addition, 16 dogs that received overdoses could not be distinguished from 29 dogs that received appropriate doses.
UC:C does not provide a consistent, correct assessment of mitotane-induced adrenocortical destruction. The ACTH stimulation test, although more time-consuming and expensive, is recommended for monitoring response to mitotane treatment.
评估尿皮质醇与肌酐比值（UC:C）作为监测垂体依赖性肾上腺皮质功能亢进犬长期米托坦治疗反应的一种手段。
前瞻性非对照研究。
101只垂体依赖性肾上腺皮质功能亢进犬。
在进行促肾上腺皮质激素（ACTH）刺激试验的当天早晨采集犬的尿液样本，并询问犬主对其犬健康状况的看法以监测米托坦治疗的反应。检测尿液中的皮质醇和肌酐浓度，并计算UC:C。将UC:C与ACTH刺激试验后血浆皮质醇浓度进行比较。
ACTH刺激试验后血浆皮质醇浓度用于对每只犬对米托坦治疗的反应进行分类。UC:C与ACTH刺激试验结果的相关性不令人满意。85只犬中有27只（32%）使用UC:C会被错误地认为接受了适当剂量的治疗。此外，16只接受过量治疗的犬无法与29只接受适当剂量治疗的犬区分开来。
UC:C不能对米托坦引起的肾上腺皮质破坏提供一致、正确的评估。尽管ACTH刺激试验更耗时且成本更高，但推荐用于监测米托坦治疗的反应。
