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总血浆皮质醇测定可因血浆蛋白和皮质醇结合力的变化而造成误差。影响蛋白皮质醇结合力的因素如:口服避孕药、妊娠或皮质醇结合球蛋白先天性异常等。唾液中皮质醇代表血浆皮质醇的游离成份,其水平很少受蛋白结合力的影响,已有人用于下丘脑-垂体-肾上腺皮质疾病的研究。作者对皮质醇增多症6例、假性皮质醇增多症(妊娠、服避孕药)和正常人的血、唾液皮质醇测定进行了比较。发现正常组于早晨9时和夜间24时的血和唾液皮质醇水平有明显差异(P<0.001),这种差异与皮质醇24小时生理节律相一致;而皮质醇增多症组的血和唾液皮质醇水平于早晚无明显差异。行地塞米松抑制试验(静脉点滴地塞米松磷酸钠1mg/h共
Total plasma cortisol determination may result from variations in the binding capacity of plasma proteins and cortisol. Affect the protein cortisol binding factors such as: oral contraceptives, pregnancy or cortisol-binding globulin congenital abnormalities. Salivary cortisol represents the free component of plasma cortisol and its level is less affected by protein binding and has been used in the study of hypothalamic-pituitary-adrenal cortical diseases. The author of cortisol hyperactivity in 6 cases, pseudocortisonemia (pregnancy, taking birth control pills) and normal blood, saliva cortisol determination were compared. Significant differences in blood and saliva cortisol levels were found between the normal group at 9:00 am and at midnight (P <0.001), which was consistent with the 24-hour circadian rhythm of cortisol. In the cortisol group, blood and saliva Cortisol levels no difference in the morning and evening. Dexamethasone inhibition test (intravenous dexamethasone sodium phosphate 1mg / h total