|
Objective: To observe the normal adult right intravenous 1μg, 50μgACTH1-39 response, preliminary study of cortisol after rapid ACTH stimulation test reference range, to carry out the diagnostic tests for clinical guidance. Methods: The subjects recorded before drug use, demographic characteristics, physical examination, laboratory tests (blood, urine, stool routine, women of childbearing age row pregnancy test, fasting blood glucose, serum potassium, liver function, renal function, cortisol rhythm, A successful check, intraocular pressure, ECG) strict screening 100 healthy subjects before the test on the 1st and tests - Part 1 12:00 evening to the next day after the fasting blood ends. Test Day 1 row 1μg rapid ACTH stimulation test. Morning 7:00 indwelling intravenous catheter, sit-ins to 8:00 the first blood samples taken immediately after intravenous injection 0.5μg/mlACTH solution 2ml, then after injection, respectively, 15min, 30min, 60min, 120min blood. Test Day 2 line 50μg rapid ACTH stimulation test. 7:30 to 8:00 morning meditation drawn first blood samples immediately after intravenous injection 25μg/mlACTH solution 2ml, respectively, after injection 15min, 30min, 60min, 120min, 180min blood. Before the test specimens from the 1st and test on the first day, the second day 24h urine specimens, recording urine output, Aliquot to be uniform testing. Throughout the trial process to avoid over-stimulation and mental stress, ban tea and coffee. Female subjects being tested to avoid the menstrual period. All the same subjects blood and urine specimens were in the same batch by chemiluminescent immunoassay. Results: (1) a total of 100 healthy volunteers were enrolled, male and female, aged 22 years to 59 years (M = 24 years old), completed two times faster ACTH stimulation test. (2) test the first and second day basal plasma cortisol was no significant difference (p gt; 0.05). (3) after intravenous 1μgACTH plasma cortisol increased rapidly, 51 people 30min peak, 49 people 60min peak, the peak of (7673 ± 107) nmol / L, based on plasma cortisol (1.9 ± 0.4) times, to 120min recovered baseline; plasma cortisol after intravenous 50μgACTH gradually increased, the basic 120min peak, peak (1093.8μ120.1) nmol / L, based on plasma cortisol (2.8 ± 0.6) times that seen in 180min a downward trend. (4) ACTH dosage and blood cortisol affects the reaction times (p lt; 0.01). (5) in two doses provocation test found no influence of gender on plasma cortisol response (p gt; 0.05). (6) intravenous 1μg, 50μgACTH urinary free cortisol after 24h 24h, respectively, based on urinary free cortisol (1.4 ± 0.5) times, (4.9 ± 1.3) times. Conclusions: (1) 1μg rapid ACTH stimulation test should normally peak plasma cortisol ≥ 591.3nmol / L, peak time for the intravenous injection of 1μg ACTH after 30min or 60min. (2) 50μg rapid ACTH stimulation test should normally peak plasma cortisol ≥ 896.2nmol / L, peak time for the intravenous injection 50μgACTH after 120min, 24h urinary free cortisol can be observed as a secondary project, normal should be based on more than 2.8 times
|