plasma cortisol

Cortisol is secreted by the adrenal cortical bundle and exists in both the bound and free forms in the blood. Free cortisol accounts for only about 10%, is biologically active, and can be filtered from the kidney; the binding state is mainly combined with glucocorticosteroid-binding protein (CBG), a small amount binds to albumin, has no biological activity, is not Hepatocyte destruction cannot be filtered from the glomerulus. The secretion of cortisol is mainly regulated by adrenocorticotropic hormone secreted by the pituitary gland. Its secretion has obvious circadian rhythm. The secretion reaches a peak at around 8 am, and then gradually decreases, and the lowest at midnight. Cortisol plays an important role in the body's metabolism, immune function and physiological functions of various organs. Basic Information Specialist classification: growth and development check classification: endocrine examination Applicable gender: whether men and women apply fasting: fasting Analysis results: Below normal: Primary or secondary adrenal insufficiency, familial glucocorticosteroid-binding protein (CBG) deficiency, Graves' disease, hypoproteinemia, severe liver disease, or kidney disease. Long-term use of drugs such as glucocorticoids, sedatives, and central antihypertensive drugs can also reduce cortisol levels. Normal value: Plasma cortisol (8-9 am: 166 nmol/L-718 nmol/Lnmol/L) Plasma cortisol (3 to 4 am: 55 nmol/L - 387 nmol/Lnmol/L) Above normal: In patients with hypercortisol caused by hyperplasia, adenoma, and cancer, the plasma, 24-hour urine, and cortisol content in saliva were significantly increased, and the circadian rhythm disappeared. Patients with pituitary ACTH and ectopic ACTH syndrome may have a corresponding increase in plasma cortisol due to increased secretion of ACTH. High corticosteroid steroid-binding protein (CBG) blood cortisol levels were significantly increased due to various causes. Cortisol can also be elevated in obesity as well as in critical illnesses such as myocardial infarction, cerebrovascular accidents, and shock. negative: Positive: Tips: Due to the physiological fluctuation of cortisol in the blood, it is the highest in the morning, gradually decreases afterwards, and falls to the lowest level after falling asleep. Clinically, blood samples are generally taken at around 8:00 in the morning for examination. Normal value Plasma 8:9 am (442 ± 276) nmol / L, 3 ~ 4 pm (221 ± 166) nmol / L. Clinical significance (1) Patients with hypercortisol caused by hyperplasia, adenoma, carcinogenesis, etc., plasma, 24-hour urine and cortisol content in saliva were significantly increased, and the circadian rhythm disappeared. Patients with pituitary ACTH and ectopic ACTH syndrome may have a corresponding increase in plasma cortisol due to increased secretion of ACTH. High corticosteroid steroid-binding protein (CBG) blood cortisol levels were significantly increased due to various causes. Cortisol can also be elevated in obesity as well as in critical illnesses such as myocardial infarction, cerebrovascular accidents, and shock. (2) Diseases with decreased cortisol concentration: primary or secondary adrenal insufficiency, familial glucocorticoid binding protein (CBG) deficiency, Graves' disease, hypoproteinemia, severe liver disease or kidney disease Wait. Long-term use of drugs such as glucocorticoids, sedatives, and central antihypertensive drugs can also reduce cortisol levels. Low results may be diseases: secondary adrenal insufficiency, high Graves disease may be diseases: adrenal insufficiency heart disease, pituitary adenoma, congenital adrenal hyperplasia Due to the physiological fluctuation of cortisol in the blood, it is the highest in the morning, and then gradually decreases, and falls to the lowest level after falling asleep. Clinically, blood samples are generally taken at around 8:00 in the morning for examination. Inspection process 1 Take plasma or standard 0.1ml into the glass tube, add 0.9ml of normal saline, mix and put in boiling water bath for 5min. Immediately take out the cooling. 2 Take a 10mm × 75mm plastic tube and add samples and reagents. 3 Add the separating agent, put it at 4 ° C for 20 min, centrifuge (3500r / min 4 ° C) for 15min. The supernatant was decanted into a counter tube, and the radioactivity was measured, and the sample value was directly obtained from the standard curve. 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.