肾上腺疾病的诊断与治疗课件.pptxVIP

肾上腺疾病

北大医院内分泌科袁戈恒

1

肾上腺皮质激素

·盐皮质激素(Aldosterone)球状带(

5%)醛固酮RAAS

·糖皮质激素(Glucocorticoid)束状带(

70%)皮质醇ACTH

·性激素(sexhormone)网状带(25%)脱氢异雄酮雄稀二酮雌激素(少)(对于男性作用弱；女性重要：机体雄激素一半来自肾上腺)

2

EnzymaticSteps:

1.CYP11A:20,22-Hydroxylase

20.22-Desmolase

2.3β-HydroxysteroidDehydrogenase

A5-A⁴Isomerase

3.CYP17:17aHydroxylase(3a)

17.20-Lyase(3b)

4.CYP21:21-Hydroxylase

5.CYP11B1:118-Hydroxylase

6.CYP11B2:11β-Hydroxylase(6a

18-Hydroxylase(6b)

18-Oxidase(6c)

7.17-KetosteroidReductase

B.CYP19:Aromatase

9.3β-Hydroxyst