Abstract:

[Abstract] Objective  To study the effects of different types of glucocorticoid (GC) on the serum cortisol (COR) and adrenocorticotropic hormone (ACTH) in patients with non-frequently relapsing nephrotic syndrome (PNS). Methods  Sixty patients with non-frequent relapses PNS were randomly divided into prednisone group (Ⅰgroup), triamcinolone group (Ⅱ group) and methylprednisolone group (Ⅲ group). Each of them was treated with standard glucocorticoid therapy. The serum levels of cortisol and ACTH were observed before treatment (A phase), the end of remission phase (B phase), the day after using 1 mg·kg-1·d -1 prednisone (C phase), the day after using 0.25 mg·kg-1·d -1 prednisone (D phase) and 4 weeks after the end of glucocorticoid therapy (E phase). Results There were significant differences in the serum COR levels in the B phase between three groups (P < 0.05). There were also significant differences in the serum COR levels of Ⅰgroup between A phase and B phase, C phase and D phase (P < 0.05 orP < 0.01), and there was significant difference between B phase and D phase (P < 0.05). There were no significant differences in the serum COR levels between D phase and A phase of Ⅱgroup, and between C phase and A phase of Ⅲ group (P > 0.05). There were significant differences in the serum ACTH levels between B phase and A phase of three groups (P < 0.05). The serum ACTH levels were higher in D phase than those in A phase of Ⅰ group and Ⅱgroup. The serum ACTH level was higher in C phase than that of A phase in Ⅲgroup (P < 0.05). The serum ACTH level was still higher in E phase than that of A phase in Ⅰgroup, but the level returned to A phase from E phase in Ⅱ group and Ⅲgroup. Conclusion  Triamcinolone is the most obvious impact on the serum COR level. Prednisone affects the smallest and is the slowest recovery. Methylprednisolone shows the fastest recovery. The inhibitory effect of prednisone on pituitary function is longer than that of triamcinolone and methylprednisolone.

Key words: Glucocorticoid, Nephrotic syndrome, Cortisol, ACTH