在上腺功能不充分的低血糖症
Shien Chen Lee1, Elizabeth S Baranowski2, Rajesh Sakremath1
1Department of Paediatrics, Princess Royal Hospital, Telford, United Kingdom.
Frontiers in endocrinology
|December 6, 2023
概括
上腺功能不良导致不充分的类固醇生产,导致低血糖症,特别是在新生儿中. 早期识别和管理策略对于防止严重结果至关重要.
科学领域:
- 内分泌学 在内分泌学.
- 儿科内分泌学 儿科内分泌学
- 代谢障碍 代谢障碍 代谢障碍
背景情况:
- 上腺功能缺陷 (AI) 是由于上腺腺不够产生类固醇 (葡萄皮质类固醇,矿物质类固醇,雄激素) 的结果.
- 人工智能可以是初级的 (上腺),二级的 (垂体ACTH) 或三级的 (下丘脑CRH),具有先天性和获得的原因.
- 由于21-基酶缺乏的先天性上腺增生 (CAH) 是一种常见的遗传原因,影响1万-15,000名新生儿中的1名.
研究的目的:
- 审查上腺功能不充分的低血糖病变.
- 探索AI中低血糖症的特定年龄临床特征和疾病负担.
- 总结改善AI中低血糖的识别和预防的策略.
主要方法:
- 文献综述侧重于病变发生,临床特征和上腺功能不足时低血糖的管理.
- 对特定年龄的表现和疾病负担的分析.
- 综合基于证据的低血糖预防和管理策略.
主要成果:
- 低血糖是AI的关键临床特征,与皮质醇在葡萄糖稳态和逆调节机制中的作用有关.
- 新生儿特别容易受到伤害,但年龄较大的儿童和患有AI的成年人也处于风险之中.
- 不同的AI病因呈现出不同的低血糖事件和疾病负担.
结论:
- 低血糖是上腺功能不全的严重并发症,需要仔细监测和管理.
- 在所有年龄组中早期识别低血糖症状对于预防严重后果至关重要.
- 持续的葡萄糖监测和调整的葡萄糖皮质激素替代等策略可以改善AI的低血糖管理.
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