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Dexamethasone suppression test

内分泌

关键词内分泌 诊断技术 肾上腺功能

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解析

dexamethasone   英/,deksə'meθəsəʊn; -zəʊn/   美 /,dɛksə'mɛθə,son; ,dɛksə'mɛθə,zon/

释    义   n. [药] 地塞米松;氟美松(抗炎药)

例    句   Purpose To study the permeability of dexamethasone through cryopreserved amniotic membrane. 目的研究冷冻保存羊膜对地塞米松的通透性。

 

suppression   英 /səˈpreʃn/   美 /səˈpreʃn/

释    义   n. 抑制;镇压;[植] 压抑

同根词   suppressed adj. 抑制的,发育不全的

               suppressant n. 抑制药

               suppressed v. 镇压,禁止

               suppress vt. 抑制;镇压;废止

例    句   Because of the great cause of this suppression of the weak sentiments .因为伟大的事业抑制了这种软弱的感情。

 

test   英 /test/

释    义   n. 测验,考查;测试;检验;化验

               v. 测验;化验,检查;试验,测试;考验

例    句   Please don't, if you are up here, become complacent because a month from now we will have another test.如果你考得不错的话,请不要自满,因为在一个月后我们将还有一次测试。

概述

地塞米松抑制试验(DST)是通过注射不同剂量地塞米松测量功能皮质醇水平以测量肾上腺功能的实验。它通常用于诊断库欣综合症,地塞米松是一种外源性类固醇,可向垂体提供负反馈,从而抑制促肾上腺皮质激素(ACTH)的分泌。 过程一般过程:一夜小剂量:晚上11点服用1毫克的地塞米松,第二天早上8点,医疗保健人员会抽取血液进行皮质醇测量。隔夜大剂量:提供者将在测试的早晨测量患者的皮质醇,然后,在晚上11点接受8毫克地塞米松,第二天早上8点,将抽血进行皮质醇测量。较少使用的过程:标准低剂量尿液:在3天内收集

The Very Low-Dose Dexamethasone Suppression Test in the General Population: A Cross-Sectional Study复制标题

普通人群的极低剂量地塞米松抑制试验: 一项横断面研究

发表时间:2016-11-01

影响因子:2.8

作者: Nese Direk

期刊:PLoS One

The hypothalamic-pituitary-adrenal (HPA) axis controls the stress response in the body. To explain the relation between diurnal HPA axis functioning and metabolic or stress-related disorders in large cohorts of healthy persons, researchers relied on single morning blood measures or used repeated saliva sampling. Different measures of the HPA axis such as cortisol awakening response, diurnal decline and total cortisol exposure over the day have been assessed using mostly saliva. More recently, cortisol assessment in hair became possible. In contrast, negative feedback of the HPA axis is rarely tested in non-clinical studies. In clinical populations, the negative feedback of the HPA axis is assessed by a dexamethasone suppression test (DST) requiring oral administration of a dose of dexamethasone. Cortisol secretion after dexamethasone intake is typically suppressed. A non-suppression indicates hypercortisolemia but DST proved very difficult to implement in population-based studies. The DST was originally designed to diagnose patients with Cushing’s Syndrome using 1 mg or higher doses of dexamethasone with a cut-off value for the plasma cortisol to distinguish between non-suppressors and suppressors. A dose of 1 mg in the conventional DST fully suppresses the HPA axis in most persons from a non-clinical population. Furthermore, the traditional “black and white” outcome definition of the negative feedback of the HPA axis masks any variation across the continuum of HPA axis reactivity. To this aim, cut-points were defined for the conventional DST, which relies on plasma cortisol to define suppression. In this population-based study, we tested the determinants of the negative feedback of the HPA axis with a very low-dose DST (0.25 mg) and assessed the outcome (suppression) continuously. Different determinants of the suppression or non-suppression after DST have been explored in the last decades. Over the years, the DST became perhaps the most common function test in clinically depressed persons. However, like in other psychiatric disorders including post-traumatic stress disorders, anxiety disorders, eating disorders, psychosis, personality traits, results of this test are inconsistent.

译文

下丘脑-垂体-肾上腺(HPA)轴控制体内的压力反应。为了解释大批健康人的昼夜HPA轴功能与代谢或与压力相关的疾病之间的关系,研究人员采用了单早采血的方法或反复进行唾液采样。大部分使用唾液评估了HPA轴的不同指标,例如一天中的皮质醇苏醒响应,昼夜下降和皮质醇总量。最近,头发中的皮质醇评估成为可能。相反,在非临床研究中很少测试HPA轴的负反馈。在临床人群中,HPA轴的负反馈通过需要口服地塞米松剂量的地塞米松抑制试验(DST)进行评估。地塞米松摄入后的皮质醇分泌通常被抑制。非抑制表示高皮质醇血症,但事实证明DST在基于人群的研究中很难实施。 DST最初旨在使用1毫克或更高剂量的地塞米松(具有血浆皮质醇的临界值)来诊断库欣综合症患者,以区分非抑制剂和抑制剂。常规DST中的1 mg剂量可完全抑制大多数非临床人群的HPA轴。此外,HPA轴负反馈的传统“黑白”结果定义掩盖了整个HPA轴反应性的变化。为此,为常规DST定义了切点,DST依赖于血浆皮质醇来定义抑制作用。在这项基于人群的研究中,我们用非常低剂量的DST(0.25 mg)测试了HPA轴负反馈的决定因素,并连续评估了结果(抑制)。在过去的几十年中,人们探索了DST后抑制或不抑制的不同决定因素。多年来,DST可能已成为临床抑郁症患者中最常见的功能测试。但是,就像其他精神疾病一样,包括创伤后应激障碍,焦虑症,进食障碍,精神病,人格特质,该测试的结果不一致。