Dexamethasone suppression test

Normal people take oral dexamethasone 3 mg daily (ie, small dose method), take 4 times, and take 2 to 3 days. Obesity patients with urinary 17 hydroxy can be high, but after suppression of small doses of dexamethasone, often can be suppressed as normal people. Basic Information Specialist classification: growth and development check classification: endocrine examination Applicable gender: whether men and women apply fasting: fasting Analysis results: Below normal: normal. Normal value: Urine 17 hydroxy: 0% of the control value Above normal: In patients with adrenal hyperfunction, whether the pathogen is hyperplasia or tumor, the inhibition is generally no more than 50% of the control value. If the dexamethasone is inhibited at a small dose, the 17-hydroxyl urinary still has no significant decrease. Instead, the high-dose method (ie, 9 mg per day) is used. At this time, the 17-hydroxyl of urine is reduced to less than 50% of the control value, indicating that the adrenal cortex may proliferate; Most of them were adrenal cortical tumors without significant changes. negative: Positive: Tips: Be careful not to bring non-urine ingredients into the urine. Send urine volume: generally 5 ~ 10ml. Normal value The urinary 17 hydroxy group was reduced to less than 0.50 (50%) of the control value. Clinical significance (1) Obesity patients with urinary 17 hydroxy can be high, but after suppression of small doses of dexamethasone, often can be suppressed as normal people. (2) In patients with hyperthyroidism, under the action of dexamethasone, the decrease of 17-hydroxyl in urine is not as significant as that of normal people. (3) Patients with adrenal hyperfunction, regardless of whether the pathogen is hyperplasia or tumor, the inhibition is generally not more than 50% of the control value. If the dexamethasone is inhibited at a small dose, the 17-hydroxyl urinary still has no significant decrease. Instead, the high-dose method (ie, 9 mg per day) is used. At this time, the 17-hydroxyl of urine is reduced to less than 50% of the control value, indicating that the adrenal cortex may proliferate; Most of them were adrenal cortical tumors without significant changes. High results may be diseases: pediatric Cushing syndrome, pediatric precocious puberty, pregnancy with hypercortisolism, follicular gland cell proliferation syndrome, pituitary adenoma, polycystic ovary syndrome, hirsutism in women, female precocious puberty, Cushing Syndrome, male precocious puberty Care should be taken not to bring non-urine ingredients into the urine: such as female patients do not mix vaginal discharge and menstrual blood, male patients should not mix with prostatic fluid. Check the urine volume: generally 5 ~ 10ml, if you want to measure the specific gravity of the urine can not be less than 50ml. Inspection process There are three common methods used in clinical practice. 1. Overnight dexamethasone suppression test 1 mg of oral dexamethasone before bedtime (about 12:00 pm), fasted until 8:00 am the next day, and blood plasma corticol was measured. In normal people and obese people, plasma cortisol can be inhibited to less than 50 μg / L, and hypercortisolism is not inhibited. 2, low-dose dexamethasone inhibition test before the test for 24h urine test 17-hydroxysteroids, the first 1-2 days of the test dexamethasone 0.5mg, or 0.75mg every 6h, every 8h1, 24h urine test 17- Hydroxysteroids. In normal people or obese people, 17-hydroxysteroid discharge is significantly reduced, which can be reduced to less than 2.5 mg or less than 50% of the control value, while patients with hypercortisolism are not inhibited. 3, high-dose dexamethasone inhibition test method and small doses, but the dosage of dexamethasone was changed to 2mg oral dexamethasone every 6h, a total of 16mg for 2d. Cortisol is caused by adrenal hyperplasia, and the urinary 17-hydroxysteroid discharge can be reduced by more than 50%, but the tumor is not inhibited (including cortical adenoma, adenocarcinoma, and ectopic ACTH syndrome). Not suitable for the crowd People with reduced hematopoietic function such as leukemia, various anemia, myelodysplastic syndrome, or people with thrombocytopenia should pay attention to blood draw, and should not take more or more blood. Adverse reactions and risks 1. After the blood is drawn, do not press the needle hole to avoid subcutaneous hematoma. If there is a small piece of bruise in the blood, it is slightly tender, please don't panic, you can do hot compress after 24 hours to promote the absorption of blood. The general small amount of congestion will gradually absorb in 3 to 5 days and the color will become lighter and return to normal. 2. After the blood draw, symptoms such as dizziness, vertigo, fatigue, etc. should be immediately supine, drink a small amount of syrup, and then undergo a physical examination after the symptoms are relieved.