低垂体症
Claire E Higham1, Gudmundur Johannsson2, Stephen M Shalet1
1Department of Endocrinology, Christie Hospital NHS Foundation Trust, Manchester, UK; Centre for Endocrinology and Diabetes, Institute of Human Development, Faculty of Medical and Human Sciences, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK.
Lancet (London, England)
|April 5, 2016
概括
下垂体荷尔蒙的缺乏会增加死亡风险,特别是由于皮质醇缺乏. 及时诊断和激素替代疗法对于治疗这种疾病至关重要.
科学领域:
- 内分泌学
- 内部医学
背景情况:
- 低垂体症涉及一个或多个垂体激素的缺乏.
- 由于上腺皮质激素 (ACTH) 缺乏而导致的皮质醇缺乏是下垂体过度死亡的主要危险因素.
- 在成年人中, 下垂体腺瘤,手术和放射治疗是常见的原因.
研究的目的:
- 提供关于下垂体病的全面概述.
- 概述诊断方法和管理策略.
- 强调激素替代疗法的关键方面.
主要方法:
- 诊断包括对某些荷尔蒙缺乏的初始血液采样.
- 通常需要动态刺激测试来评估ACTH,生长激素和抗尿激素缺乏.
- 对于缓慢演变的形式,需要定期重新评估垂体功能.
主要成果:
- 替代疗法包括甲状腺素,皮,性类固醇,生长激素和德斯莫普林素.
- 在急性发病时,优先补充皮质醇缺乏.
- 治疗需要在儿童到成人的过渡和怀孕期间进行修改.
结论:
- 有效治疗下垂体依赖于准确的诊断和及时的激素替代.
- 密切监测和量身定制的治疗调整对于最佳的患者结果至关重要.
- 了解各种原因和治疗细微差别对于临床医生来说至关重要.
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