脳神経外科領域におけるGlucocorticoid投与法の検討（第3報）—Betamethasone 8mg投与後の血中cortisol濃度の推移について

Clinical Evaluation on Glucocorticoid Administration in the Neurosurgical Patients (the Third Report):Serial Plasma Cortisol Assay following Betamethasone 8mg Intravenous Injection

Ⅰ．緒言

　脳神経外科実地臨床上，脳浮腫の予防治療に用いられる大量のglucocorticoidの作用機序^15）およびその効果発現の時期^9），持続時間についてはいまだに十分な解明がなされておらず，各臨床医が脳浮腫の発生する状況に応じて経験的に投与しているのが現状である．

　我々はglucocorticoidの脳浮腫に対する最も有効で副作用の少ない投与法，投与量の確立を目指しており，現在まで第1報にglucocorticoid投与下にmajor neurological surgeryを受けた患者における手術前後の下垂体ホルモン分泌能の変化^6）を，第2報にヒト静脈内に投与されたhydrocortisoneの髄液内への移行濃度を経時的に測定し報告した^17）．

The effect of betamethasone on plasma cortisol concentrations was studied in 6 healthy adult men. Each of them was administered 8mg of betamethasone in a single intravenous injection. Blood samples were obtained serially for 2 days before the injection of betamethasone and for a week after the injection. Plasma cortisol was measured by competitive protein binding analysis. Before the injection of betamethasone plasma cortisol levels showed the normal diurnal rythm in all the cases. After the injection plasma cortisol levels decreased rapidly and a mean half life time was about 1.7 hours.