论文部分内容阅读
为探讨慢性阻塞性肺疾病（ＣＯＰＤ）急性发作期肾上腺皮质功能及垂体－肾上腺皮质轴变化的关系，对５６例ＣＯＰＤ患者进行了血浆皮质醇（Ｆ）和促肾上腺皮质激素（ＡＣＴＨ）的测定。并依年龄组（３７～５９岁，６０～７５岁）及男女性别不同进行了比较，结果与正常对照组相比，不同年龄组３２例单纯ＣＯＰＤ患者Ｆ显著降低（Ｐ＜０．０５），ＡＣＴＨ增高（Ｐ＞０．０５），２４例合并肺心病患者Ｆ显著增高（Ｐ＜０．０５），ＡＣＴＨ降低（Ｐ＞０．０５），合并肺心病组与单纯ＣＯＰＤ组相比较Ｆ显著增高（Ｐ＜０．０５），血浆ＡＣＴＨ６０～７５岁年龄组显著降低（Ｐ＜０．０５），而３７～５９岁年龄组降低不明显（Ｐ＞０．０５）。男性ＣＯＰＤ组与正常组相比较Ｆ显著降低（Ｐ＜０．０５），ＡＣＴＨ增高（Ｐ＞０．０５），合并肺心病组较正常组及ＣＯＰＤ组均为Ｆ显著性增高（Ｐ＜０．０５），ＡＣＴＨ显著性降低（Ｐ＜０．０５）。但女性各组之间无显著性变化（Ｐ＞０．０５）。提示肺心病患者肾上腺皮质功能并不低下。ＡＣＴＨ降低可能与Ｆ对ＡＣＴＨ的负反馈作用有关。女性ＣＯＰＤ患者此变化不明显。在ＣＯＰＤ向肺心病发展过程中特别是男性垂体－肾上腺皮质轴激素起着明显的变化
To investigate the relationship between adrenocortical function and changes of pituitary-adrenocortical axis in patients with chronic obstructive pulmonary disease (COPD) at acute stage, 56 patients with COPD were enrolled in this study. Plasma Cortisol (F) and adrenocorticotrophic hormone (ACTH) were measured. The results were compared with those of the normal control group (P <0.05). The results showed that F of 32 patients with COPD in different age groups was significantly lower than that of the normal control group (P <0.05) (P> 0.05). F in 24 patients with pulmonary heart disease was significantly higher (P <0.05) and ACTH was lower (P> 0.05), F was significantly higher in patients with pulmonary heart disease and COPD group (P <0.05). Plasma ACTH was significantly lower in the age group of 60-75 years (P <0.05), while it was not significantly reduced in the age group of 37-59 years (P> 0.05). Compared with the normal group, F in COPD group was significantly lower (P <0.05) and ACTH was higher (P> 0.05). Compared with normal group and COPD group, F in COPD group was significantly increased (P <0. 05), ACTH decreased significantly (P <0.05). However, there was no significant change between female groups (P> 0.05). Prompted adrenal function in patients with pulmonary heart disease is not low. The decrease of ACTH may be related to the negative feedback effect of F on ACTH. This change is not obvious in women with COPD. In COPD to the development of pulmonary heart disease, especially in the male pituitary - adrenocorticotropic hormone plays a significant change