在SARS-CoV-2中,下丘脑-垂体-上腺轴活动 感染非危急病患者 住院患者
Hurjahan Banu1, Nusrat Sultana1, Morshed Md Shahed2
1Department of Endocrinology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Shahbag, Dhaka, Bangladesh.
Journal of the ASEAN Federation of Endocrine Societies
|December 4, 2023
概括
在住院的COVID-19患者中,上腺功能缺陷很常见,特别是那些患有严重疾病的人. 在非临界的COVID-19严重程度组中,荷尔蒙水平保持相似,表明上腺皮质反应受损.
科学领域:
- 内分泌学 在内分泌学.
- 传染性疾病 传染性疾病
- 内部医学 内部医学
背景情况:
- 下垂体-垂体-上腺 (HPA) 轴在应激反应中起着至关重要的作用.
- 冠状病毒疾病2019 (COVID-19) 可以影响包括内分泌系统在内的各种器官系统.
- 在非临界的COVID-19中了解HPA轴功能对于患者管理至关重要.
研究的目的:
- 为了确定基线HPA轴激素水平在非危急病入院的COVID-19患者.
- 在这个人群中确定与HPA轴功能障碍相关的因素.
- 为了评估与COVID-19严重程度相关的上腺功能缺陷的患病率.
主要方法:
- 对91名非临界,RT-PCR确诊的COVID-19患者 (年龄在18-65岁之间) 的横截面研究.
- 血液样本是在禁食后的早上收集的,以测量血清皮质醇和血ACTH.
- 使用化学发光微粒免疫测试分析的荷尔蒙水平.
主要成果:
- 上腺功能不充分,由276nmol/L的皮质醇切断定义,在27.3%的严重,25.9%的轻度和3.8%的中度COVID-19病例中观察到.
- 在轻度,中度和严重的COVID-19组中,血清皮质醇和血ACTH水平的中位数相似 (分别为p=0.057和p=0.910).
- 根据皮质醇/ACTH比率>15.5,只有6.6%的患者有足够的上腺储备.
结论:
- 在非危急的COVID-19患者中,有很大比例的患者表现出受损的上腺皮质反应.
- 上腺功能缺陷的最高患病率是在重症COVID-19患者中发现的.
- 尽管严重程度各不相同,但HPA轴的参数,如血清皮质醇和血ACTH,在非危急的COVID-19患者中是可比的.
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