【摘要】 目的探讨利福平对过夜1.5mg地塞米松抑制试验的影响及停用利福平后该试验恢复正常的时间。方法25例轻症肺结核患者分别于利福平治疗前、治疗10d(450mg/d)时及停药1,2,3周进行过夜1.5mg地塞米松抑制试验。结果利福平治疗使所有患者正常的过夜1.5mg地塞米松抑制试验(血浆皮质醇(371±110)vs.(57±29)nmol/L,P<0.01)均变为异常(349±105)vs.(326±100)nmol/L,P>0.05)。停药1,2及3周时,该抑制试验分别为(356±105)vs.(243±88)nmol/L(P<0.05),(340±102)vs.(97±105)nmol/L(P<0.01)和(352±102)vs.(64±33)nmol/L(P<0.01),恢复正常反应各占24.0%,79.2%和95.2%。结论在利福平治疗期间,过夜1.5mg地塞米松抑制试验不具备鉴别库欣综合征价值,必须应用该试验鉴别诊断时宜停药3周以上。更多还原

【Abstract】 Objective: To explore the effect of rifampicin on overnight 1.5 mg dexamethasone suppression test and its recovery after rifampicin with drawal. Methods: The test was performed before, at 0, 1, 2 and 3 weeks, respectively, after rifampicin treatment (450 mg/d, for 10 days) in 25 patients with pulmonary tuberculosis. Results: Rifampicin therapy rendered the tests abnormal (plasma cortisol (349±105) vs. (326±100) nmol/L, P<0.05). In all patients with normal overnight 1.5 mg dexamethasone suppression test [(371±110) vs. (57±29) nmol/L, P<0.001] before rifampicin treatment. After rifampicin with drawal, the tests were (356±105) vs. (243±88), at the 1st week (P<0.05), (340±102) vs. (97±35), at the 2nd week (P<0.01) and (352±107) vs. (64±33), at the 3rd week (P<0.01), and the corresponding normal tests were 24.0%, 79.2% and 95.2%, respectively. Conclusion: The results show that overnight 1.5 mg dexamethasone suppression test has no clinical value in diagnosing cushing′s syndrome during treatment with rifampicin and it is prudent to discontinue rifampicin therapy for 3 weeks at least before performance of the test if necessary.更多还原