在接受多次类固醇注射的患者中,查血清皮质醇水平以检查显著的下丘脑-垂体-上腺轴抑制
Debbie Lee1, Eduardo J Carrera2, Ryan Hagens3
1Department of Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, United States.
Pain medicine (Malden, Mass.)
|October 11, 2023
概括
清晨血清皮质醇水平 (mSCL) 可以选下丘脑-垂体-上腺 (HPA) 轴抑制. 这项研究没有发现累积葡萄糖皮质激素剂量与HPA轴抑制之间存在关联,但mSCL收集的时间是关键.
科学领域:
- 内分泌学 在内分泌学.
- 疼痛管理 疼痛管理
- 药理学 药理学是指药理学的学科.
背景情况:
- 清晨血清皮质醇水平 (mSCL) 是一种实用的查工具,用于抑制下丘脑-垂体-上腺 (HPA) 轴.
- 它在增加累积葡萄糖皮质醇等效剂量 (CGED) 的患者中的有用性需要进一步的证据.
研究的目的:
- 在脊柱注射候选人中估计显著的HPA轴抑制 (sigAS) 的患病率.
- 将12个月的CGED与基于mSCL时间的sigAS相关联.
- 调查与sigAS相关的人口和临床因素.
主要方法:
- 对接受mSCL脊椎注射的患者的回顾性图表审查.
- 在mSCL之前的12个月内记录了类固醇细节和计算的CGED.
- 分析了sigAS的流行率和相关因素.
主要成果:
- SigAS的患病率在7.8%至22%之间.
- 没有发现CGED和sigAS之间的关联,无论mSCL时间.
- 观察到趋势是降低mSCL和sigAS,同时增加CGED.
结论:
- 在注射后6周观察到sigAS率减少了3倍.
- mSCL时间对于识别有 sigAS 风险的患者至关重要.
- 需要指导方针来确定风险评估的最佳mSCL时间.
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