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在接受皮质类固醇治疗的患有性综合征的儿童中抑制上腺皮质抑制
Ganesh M Krishna1, Aashima Dabas1, Mukta Mantan2
1Department of Pediatrics, Maulana Azad Medical College and Lok Nayak Hospital, New Delhi, India.
Pediatric nephrology (Berlin, Germany)
|January 22, 2024
概括
患有性综合征的儿童在交替服用类固醇时,表现出较高的上腺功能不全率. 累积的类固醇剂量超过0.22mg/kg/天表明对上腺皮层抑制的风险.
科学领域:
- 儿科内分泌学 儿科内分泌学
- 儿科脏病学 儿科脏病学
- 内分泌学 在内分泌学.
背景情况:
- 患有性综合征的儿童经常接受长时间的交替日类固醇治疗.
- 这就需要使用上腺皮质激素 (ACTH) 刺激测试来评估潜在的上腺皮质抑制.
研究的目的:
- 为了确定上皮层抑制在患有性综合征的儿童中使用替代日类固醇的患病率.
- 确定与上腺功能不充分相关的类固醇剂量的预测值.
主要方法:
- 一项横截面研究包括52名儿童 (2-18岁) 患有缓解中的类固醇敏感或耐药性性综合征.
- 通过基线和ACTH刺激后的血清皮质醇水平来评估上腺皮质功能.
- 如果ACTH后1小时皮质醇<18.0μgm/dl,则诊断为上腺功能不全.
主要成果:
- 该研究发现,使用基线皮质醇,上腺功能不足的患病率为50%,使用后刺激水平,患病率为64%.
- 累计每年普得尼索隆剂量>0.22 mg/kg/day预测上皮层抑制,AUC为0.76.
- 预测模型显示了63.9%的灵敏度和81.3%的特异性.
结论:
- 患有性综合征的儿童中有很大一部分在接受交替日类固醇治疗时表现出上腺功能不充分.
- 累积的类固醇摄入量超过0.22 mg/kg/day,每隔一天是预测上腺皮层抑制的危险因素.
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