薬物負荷を中心とした尿中17-KSに関する研究

Abstract

PMS, HCG and dynamic tests were conducted to study changes in urinary 17-Ketosteroids (17-KS) during gonad stimulation, as well as to determine 17-KS values and fraction ratios after administration of SU 4885, ACTH and dexamethasone. As a result it was possible to establish the adrenal 17-KS patterns. In addition, studies were carried out on urinary 17-KS of patients with diseases of the gonad and the adreno-pituitary systems, and the following results were obtained.1) There occurs no appreciable change in the urinary 17-KS by stimulating the gonad with PMS or HCG, while it is possible to tell the gonal functions on the basis of changes in the androsterone fraction, androsterone ratio and the 11-oxy-17-KS/11-deoxy-17-KS radio, as determined by the dynamic test.2) The administration of SU 4885 increases 11-deoxy-17-KS and among 17-KS fractions DHA and etiocholanolone constitute predominant fractions.3) The administration of ACTH raises the levels of 11-oxy-17-KS and 11-deoxy-17-KS, but the increase in 11-oxy-17-KS is much greater. It has been found that androsterone, DHA, and etiocholanolone fractions are markedly increased, but androsterone ratio and DHA ratio, differing from that of etiocholanolone, have not increased.4) The administration of dexamethasone decreases every 17-KS fraction, but the decrease in 11-oxy-17-KS is greater than that of 11-deoxy-17-KS. And the androsterone fraction tend to decrease, but androsterone ratio tend to increase indicating a 17-KS mainly secreted by the gonad system.5) It has been possible to establish the 17-KS patterns of the adrenal system by this study.6) In the study of abnormal cases, it has been demonstrated that careful analysis of androsterone and 11-oxy-17-KS levels, androsterone ratio, and 11-oxy-17-KS/11-deoxy-17-KS ratio by the methods already mentioned make it possible to identify various endocrine disorders, and concurrent dynamic test enables us to abtain still more precise results.