纳络酮对正常人和Cushing病患者血N-POMC和皮质醇对CRH反应的影响

EFFECT OF NALOXONE ON THE RESPONSES OF ACTH AND CORTISOL TO CRH IN NORMAL SUBJECTS AND PATIENTS WITH CUSHING'S DISEASE

作者观察了7例Cushing病患者和6例正常人血N-POMC和皮质醇对静脉注射CRH或CRH加纳络酮的反应。Cushing病患者对CRH的反应与正常人相似;而在加用大剂量纳络酮之后,却没有如正常人一样出现进一步增高反应。纳络酮在正常人可能通过阻断类阿片肽对内源性CRH的抑制作用而使反应进一步升高;在Cushing病患者可能存在着更强的CRH抑制因素,因而加用纳络酮不起作用。

The effect of naloxone on the responses of ACTH and cortisol to CRH was studied in 7 patients with Cushing's disease and 6 normal subjects as controls. Serum N-POMC was used as indicator of ACTH secretion. The peak values of serum N-POMC after i.v. injection of oCRH1-41 in controls and patients with Cushing's disease rose 2.0±0.2 and 2.0±0.3 times respectively which were not different from each other, and the peak levels of plasma cortisol increased to the same extent as serum N-POMC which were 2.2±0.4 and 1.6±0.2 times of their basal levels respectively. These reflected that exogenous CRH could stimulate N-POMC and cortisol secretion both in normal subjects and patients with Cushing's disease. However, the additional injection of naloxone could cause a further increase of blood N- POMG and cortisol only in normal subjects, but not in pat-ients with Cushing's disease. Naloxone, by blocking the inhibitory effect of opioid peptides on CRH secretion, might cause an increase of endogenous GRH secretion which induced the further elevation of N-POMC and cortisol in normal subjects.