皮质醇对皮质激素的反应和败血性休克中的生存率
P M Rothwell1, Z F Udwadia, P G Lawler
1Intensive Therapy Unit, South Cleveland Hospital, Middlesbrough, UK.
Lancet (London, England)
|March 9, 1991
概括
患有败血性休克和对皮质激素 (腺皮质激素) 皮质醇反应差的患者的死亡率更高. 这表明相对上腺功能不足可能会影响感染性休克的结果.
科学领域:
- 内分泌学 在内分泌学.
- 关键护理医学 关键护理医学
- 败血栓冲击病理生理学
背景情况:
- 败血性休克可能导致严重疾病相关的皮质类固醇缺乏症.
- 评估上腺皮功能对于管理败血性休克患者至关重要.
研究的目的:
- 用皮质激素刺激试验评估上皮质功能,在患有败血性休克的患者.
- 为了确定皮质醇反应和败血症休克死亡率之间的相关性.
主要方法:
- 对32名被诊断患有败血性休克的患者进行了皮质otropin刺激测试.
- 测量皮质醇水平以评估对皮质激素 (ACTH) 的上腺皮质反应.
- 记录和分析了患者的结局,特别是死亡率,与皮质醇反应相关.
主要成果:
- 在32名患者中,有13名患者表现出皮质醇反应不佳 (增加<250nmol/l) 对皮质激素.
- 所有13名皮质醇反应不佳的患者都死亡.
- 在19名具有足够皮质醇反应的患者中,只有6人死亡 (p < 0.001).
结论:
- 对皮质激素刺激的皮质醇反应不佳与性休克死亡率显著增加有关.
- 相对上腺皮缺陷可能是导致一些败血症休克患者不良后果的一个因素.
- 需要进一步研究上腺功能衰竭在败血症休克中的作用.
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