Preliminary Study On Finding Out The Reference Ranges Of Cortical In Rapid ACTH Stimulation Tests.

Objectives:To find out the reference ranges of cortical in different doses (1μg,50μg) rapid ACTH stimulation tests in healthy adults.Methods:The serum cortical and urinary-free cortical (UFC) have been used as the observation indicators and 100 healthy adults have been tested 1μg and 50μg rapid ACTH stimulation tests in two days. All the 100 volunteers have been injected ACTH and the blood samples have been collected straight away after the injection, in 15 min,30min,60min,120min and 180min. Urine samples have been collected from 0800h to the next 0800h on 3 successive days.Results:1. The study were carried out on 100 (50 males and 50 females) healthy individuals with an age range of 22-59 years. All of them have been tested 1μg and 50μg ACTH stimulation tests in two days.2. The average of mean basal cortisol levels obtained before each dynamic stimulation test was calculated and it was not found to be significantly different (P>0.05).3. The intravenous injection of 1μg ACTH, the serum cortisol rose quickly. The peak cortisol responses were obtained in 51 of the volunteers in 30min and 49 of the volunteers in 60min which is (767.3±107) nmol/L.This data is about (1.9±0.4) times of the basal serum cortical rate. In 120min, the serum cortisol rate turned back to the normal level.The intravenous injection of 50μg ACTH, the serum cortisol rose in a stable way. The peak serum cortisol responses were obtained in 120min which is (1093.8±120.1) nmol/L. The peak value of serum cortisol is around (2.8±0.6) times of the basal serum cortical level. After 180min, there was a decreasing tendency of the serum cortical.4. In general, the dose of ACTH and the time of collecting blood samples both had effects on the reaction of cortisol(P＜0.01).5. In the study, there were no indicators to show that gender has effects on the reaction of serum cortical(P>0.05).6.24 hours after the intravenous injections of 1μg and 50μg ACTH, the UFC is individually (1.4±0.5) times and (4.9±1.3) times of the basal UFC level.Conclusions:1. The peak value of serum cortical should be no less than 591.3nmol/L in 1μg rapid ACTH stimulation test, and the peak cortisol responses were obtained in 30min or 60min. 2. The peak value of serum cortical should be no less than 896.2nmol/L in 50μg rapid ACTH stimulation test, the peak cortisol responses were obtained in 120min and the UFC in 24h can be the supplementary observation item, which should be 2.8 times than the normal level.