肝脏疾病中的上腺功能不全 - 病理生理学和潜在机制
Maria Kalafateli1, Ioanna Aggeletopoulou2,3, Christos Triantos4
1Department of Gastroenterology, General Hospital of Patras, 26332, Patras, Greece.
Reviews in endocrine & metabolic disorders
|February 2, 2024
概括
肝硬化中相对上腺功能缺陷 (RAI) 是常见的,影响危急和非危急的病人. 本综述探讨了复杂的原因,包括上腺和中枢下丘脑-垂体-上腺轴功能障碍,导致结果不佳.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 内分泌学 在内分泌学.
- 关键护理医学 关键护理医学
背景情况:
- 相对上腺功能缺陷 (RAI) 经常在肝硬化患者中观察到,影响危急和非危急的患者.
- 肝硬化中RAI的潜在病理生理学仍然不完全理解,需要进一步调查.
研究的目的:
- 审查和介绍潜在的机制和因果关系途径,涉及RAI在肝硬化病变的致病性.
- 综合当前关于上腺和中央下丘脑-垂体-上腺 (HPA) 轴功能障碍的证据.
主要方法:
- 文献综述综合了现有关于RAI在肝硬化中的研究.
- 对研究上腺功能,皮质醇代谢和肝硬化患者HPA轴调节的研究进行分析.
- 探索促炎媒介和抗葡萄糖皮质激素耐药性的作用.
主要成果:
- 有证据表明,由于皮质醇合成和新陈代谢的减少,肝硬化中的副腎功能在基线水平低于最佳水平.
- 人们越来越多地认识到HPA轴 (下丘脑/垂体) 中央刺激受损.
- 肝硬化中的亲炎性调解剂可能会抑制HPA轴,降低皮质醇,并诱导组织对葡萄糖皮质激素的抵抗.
结论:
- 肝上腺综合征假设认为,脱补偿期间的亚最佳上腺皮质反应会使结果恶化.
- 肝硬化中上腺功能障碍的复杂病理生理学需要进一步的研究才能完全阐明.
- 了解肝硬化中的RAI对于改善患者管理和治疗结果至关重要.
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