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題 名 | Hormonal and Hematologic Changes Associated with Adrenal Insufficiency=腎上腺低下症之荷爾蒙及血球變化的研究 |
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作 者 | 石光中; 葉振聲; 方升坤; 何橈通; 丁予安; | 書刊名 | 醫學研究 |
卷 期 | 17:1 1996.07[民85.07] |
頁 次 | 頁9-15 |
分類號 | 415.934 |
關鍵詞 | 胰島素誘發低血糖症; 腎上腺功能不足; 淋巴球過多症; Insulin hypoglycemia; Adrenal insufficiency; Lymphocytosis; |
語 文 | 英文(English) |
中文摘要 | 本研究以7位腎上腺功能不足的病患和7位年齡、性別相同的正常人為對照組,在胰島素誘發產生低血糖的狀況下測量他們週邊血液中的白血球及血漿中皮質醇和生長激素變化的情形。經過整晚空腹的狀況下,在次日上午八點對正常對照組及腎上腺功能不足的病患分別施以靜脈注射1.5U/kg及1.0U/kg標準劑量的胰島素。在注射胰島素前及注射後產生低血糖和產生低血糖後的15, 30, 60, 90分鐘同時測量其血中葡萄糖、皮質醇、生長激素濃度和白血球細胞之計數。發現腎上腺功能不足的病患其空腹血糖較正常對照組為低。胰島素注射約30分鐘後,二組血糖值均下降至30-40 mg/dL,且伴有自主神經反應,經過50%葡萄糖液注射後15分鐘,二組血糖值反彈至較空腹血糖為高,30分鐘後,血糖即恢復正常。和正常對照組相較,腎上腺功能不足的病患其皮質醇、生長激素的基礎值較低,且其皮質醇和生長激素對低血糖的反應亦受到抑制。低血糖症只使正常對照組產生暫時性的嗜伊紅細胞減少,但腎上腺功能不足的病患卻無此反應。而二組之間的粒性細胞數目並無明顯差異。總之,在急性低血糖的狀況下,腎上腺功能不足的病患會引起某些荷爾蒙和血球的變化,而這些變化在正常對照組則較少發生。 |
英文摘要 | Seven subjects with adrenal insufficiency and 7 age-and sex-matched normal subjects were recruited for a study on the changes in white blood cell counts, plasma cortisol and growth hormone concentrations in response in insulin-induced hypoglycemia. Following an overnight fast, the patients and the normal subjects received 0.1 and 0.15 U/kg body weight of regular insulin injected intravenously at 08:00 hour, respectively. Blood samples were taken before insulin injection, on the onset of an acute hypoglycemia-autonomic reaction following the insulin injection, and then at 15, 30, 60 and 90 min later. Complete blood cell counts and plasma levels of glucose, cortisol and growth hormone were determined. The patient group has a mean fasting plasma glucose value significantly lower than that of the normal control group. Near 30 min following an insulin injection, both groups reached a hypoglycemic level around 30-40 mg/dL when autonomic reactions were observed. Plasma glucose rebounded to a higher than the fasting level at 15 min and then recovered to euglycemia at 30 min following glucose injection. Compared to those of normal subjects, patients' baseline levels of plasma cortisol and growth hormone were significantly reduced and their responses to hypoglycemia were also significantly suppressed. Hypoglycemia led to a transient eosinopenia only in normal subjects, not in patients. The basal and the post-hypoglycemia lymphocytic counts were significantly higher in patients than in normal subjects. The granulocytic counts were not different between the two groups. Thus, acute hypoglycemia in patients with adrenal insufficiency resulted in some distinct hormonal and hematologic changes not observed in normal subjects. |
本系統中英文摘要資訊取自各篇刊載內容。