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有关下丘脑-垂体-肾上腺皮质轴的研究主要集中在抗癫痫药(AED)对肾上腺皮质(AC)功能的影响上,长期治疗的病人,血及尿中糖皮质类固醇激素都降低.为阐明除AED外,是否有疾病本身对AC功能的影响,作者对24例原发性,21例继发性男性癫痫病人在用AED前及治疗的2年中测定了血中孕酮,皮质醇,苯妥英(PHT)浓度及24小时尿中17-羟皮质类固醇(17-OHCS)的排泄,并与45例对照组进行了对比分析.结果发现:治疗前病人血清中孕酮,皮质醇降低者较对照组多见,其平均血清水平比对照组显著降低(P值分别为<0.01和<0.05).治疗中孕酮可达正常,而皮质醇则进一步降低(P<0.01),病人尿中皮质醇代谢物减少较对照组更多见,治疗前尿中17-OHCS排泄明显降低(P<0.01),用药中则进一步降低(P<0.01),未治疗病人中有33%异
The study on the hypothalamic-pituitary-adrenocortical axis focuses on the effect of antiepileptic drugs (AEDs) on adrenocortical (AC) function in patients with long-term treatment, blood and urine glucocorticosteroids are reduced. AED, whether the disease itself on the AC function, the author of 24 cases of primary, 21 cases of secondary male epilepsy patients with AED before and 2 years of treatment measured blood progesterone, cortisol, phenytoin (PHT) and excretion of 24-hour urinary 17-OHCS, and compared with 45 control group.The results showed that serum progesterone and cortisol in patients before treatment were lower than those in control (P <0.01 and <0.05, respectively), serum progesterone was normal and cortisol was further decreased (P <0.01), urinary cortisol Metabolites decreased more than the control group, before treatment, excretion of urinary 17-OHCS was significantly lower (P <0.01), while the drug was further reduced (P <0.01), 33% of untreated patients