皮质醇血检

定义

The cortisol blood test measures the level of cortisol in the blood. Cortisol is a steroid (glucocorticoid or corticosteroid) hormone produced by the 肾上腺.

皮质醇也可以用a 尿液 或者唾液测试.

选择的名字

血清皮质醇

如何执行测试

A 需要血液样本.

如何准备考试

Your health care provider will likely have you do the test early in the morning. This is important because cortisol level varies throughout the day.

You may be asked not to do any vigorous exercise the day before the test.

You may also be told to temporarily stop taking medicines that can affect the test, including:

• 抗癫痫药物
• 雌激素
• Human-made (synthetic) glucocorticoids, such as hydrocortisone, prednisone, 和 prednisolone
• 雄激素

考试的感觉如何

When the needle is inserted to draw blood, some people feel moderate pain. 其他人只感到刺痛或刺痛. Afterward, there may be some throbbing or slight bruising. 这很快就会消失.

为什么要进行测试

The test is done to check for increased or decreased cortisol production. Cortisol is a glucocorticoid (steroid) hormone released from the 肾上腺 in response to adrenocorticotropic hormone (ACTH). ACTH is a hormone released from the pituitary gl和 in the brain.

Cortisol affects many different body systems. 它在以下方面发挥作用:

• 骨骼生长
• 控制血压
• 免疫系统功能
• Metabolism of fats, carbohydrates, 和 protein
• 神经系统功能
• 应激反应

不同的疾病，如 库欣综合症 和 艾迪生疾病, can lead to either too much or too little production of cortisol. Measuring blood cortisol level can help diagnose these conditions. It is also measured to evaluate how well the pituitary 和 肾上腺s are working.

The test is often done before 和 1 hour after injection of a medicine called ACTH (cosyntropin). 这部分测试被称为an ACTH刺激试验. It is an important test that helps check the function of the pituitary 和 肾上腺s.

The test is often done in the morning after taking 1 milligram (mg) of dexamethasone the night before the test.

Other conditions for which the test may be ordered include:

• 急性肾上腺危机, a life-threatening condition that occurs when there is not enough cortisol
• 脓毒症, an illness in which the body has a severe response to bacteria or other germs
• 低血压

正常的结果

Normal values for a blood sample taken at 8 in the morning are 5 to 25 mcg/dL or 140 to 690 nmol/L.

Normal values depend on the time of day 和 the clinical context. Normal ranges may vary slightly among different laboratories. Some labs use different measurements or may test different specimens. Talk to your provider about the meaning of your specific test results.

The expected result can be outside the normal range if done as part of a cosyntropin stimulation test or dexamethasone suppression test.

异常结果意味着什么

A higher than normal level may indicate:

• 库欣病, in which the pituitary gl和 makes too much ACTH because of excess growth of the pituitary gl和 or a tumor in the pituitary gl和
• 异位库欣综合征, in which a tumor outside the pituitary or 肾上腺s makes too much ACTH
• Tumor of the 肾上腺 that is producing too much cortisol
• 压力
• 急性疾病

A lower than normal level may indicate:

• 艾迪生疾病, in which the 肾上腺s do not produce enough cortisol
• 垂体机能减退, in which the pituitary gl和 does not signal the 肾上腺 to produce enough cortisol
• Suppression of normal pituitary or adrenal function by glucocorticoid medicines including pills, 护肤霜, 眼药水, 吸入器, 联合注射, 化疗

风险

There is little risk involved with having your blood taken. Veins 和 arteries vary in size from one person to another 和 from one side of the body to the other. Taking blood from some people may be more difficult than from others.

Other risks associated with having blood drawn are slight, but may include:

• 大出血
• 昏厥或感到头晕
• 多次穿刺定位静脉
• Hematoma (blood accumulating under the skin)
• Infection (a slight risk any time the skin is broken)

参考文献

Guber HA, Oprea M, Russell YX. 内分泌功能评价. 见:McPherson RA, Pincus MR，编辑. Henry's Clinical Diagnosis 和 Management by Laboratory Methods. 24日艾德. Philadelphia, PA: Elsevier; 2022:chap 25.

newwell - price JDC, Auchus RJ. 肾上腺皮质. In: Melmed S, Auchus, RJ, Goldfine AB, Koenig RJ, Rosen CJ, eds. 威廉斯内分泌学教科书. 14日艾德. Philadelphia, PA: Elsevier; 2020:chap 15.