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在成年人中产生上腺功能不全的Iatrogenic
Julie Martin-Grace1,2, Maria Tomkins1,2, Michael W O'Reilly1,2
1Department of Endocrinology, Royal College of Surgeons in Ireland, Dublin, Ireland.
Nature reviews. Endocrinology
|January 25, 2024
概括
上腺功能不全 (IAI),通常是由葡萄糖皮质类药物引起的,在成年人中很常见. 早期诊断和仔细管理对于预防上腺危机和改善患者的治疗结果至关重要.
科学领域:
- 内分泌学 在内分泌学.
- 内部医学 内部医学
背景情况:
- 上腺功能缺陷 (IAI) 是成年人中最常见的上腺功能缺陷形式,但其确切的患病率尚未确定.
- IAI与严重的临床结果有关,包括上腺危机,生活质量下降和死亡率增加.
研究的目的:
- 审查IAI的原因,临床后果,诊断和管理.
- 为临床医生提供有关识别风险患者,查策略和优化IAI治疗的指导,重点关注紧急护理和上腺危机预防.
主要方法:
- 关于iatrogenic上腺功能不全的综合文献综述.
- 分析当前的治疗策略,局限性和新出现的发展.
主要成果:
- IAI管理,特别是葡萄糖皮质激素诱导的,在平衡激素替代与尽量减少不良影响方面提出了挑战.
- 优化下丘脑-垂体-上腺轴的恢复是治疗中的一个关键考虑因素.
结论:
- 对于IAI的及时诊断和管理,一个高的怀疑指数是必不可少的.
- 有效的管理需要平衡葡萄糖皮质激素替代与尽量减少心脏代谢风险和促进HPA轴恢复.
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