1-脱氨基-8-右旋精氨酸加压素刺激实验与库欣综合征

Desmopressin test and cushing's syndrome

目的探讨1-脱氨基-8-右旋精氨酸加压素刺激实验(desmop ressin,DDAVP)在库欣病(Cush-ing`s disease,CD)鉴别诊断上的可行性。方法本实验分析了DDAVP刺激对不同病因的库欣综合征(Cushing`s syndrome,CS)和正常人(normal individual,NI)的肾上腺皮质激素(Adrenocortico tropinhor-mone,ACTH)和皮质醇(cortisol,F)释放的影响。结果2/3的异位ACTH分泌综合征(ectopic ACTH secretion,EC)患者呈阳性结果。结论实验证明DDAVP测试不能作为CD的鉴别诊断方法,因为EC对DDAVP这种肽类物质的刺激呈超常反应。

[Objectives] To detect the feasibility of desmopressin （DDAVP） testing in differential diagnosis of Cushing＇s disease （CD）. [Methods] The present study assessed the effects of DDAVP on the release of ACTH and cortisol （F） when given to patients with Cushing＇s syndrome （CS） of varied etiologies and normal individuals （NI）.[Results] Interestingly, 2/3 of patients with ectopic ACTH secretion showed positive response. [Conclusions]These data provide some evidence that DDAVP testing is not an enough diagnostic tool for differential diagnosis of CD, since ectopic ACTH dependent CS patients are hyper-responsive to the peptide,