在患有内源性库辛综合征的患者中不需要进行外科皮质糖类替代治疗 - - 一项试点研究
Christian Trummer1, Marlene Pandis2, Verena Theiler-Schwetz2
1Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, Graz, Austria. christian.trummer@medunigraz.at.
Endocrine
|April 22, 2024
概括
在接受治疗性手术的库辛综合征 (CS) 患者中,可能不需要进行外科治疗的葡萄糖皮质激素治疗. 这项研究在没有接受外科手术期间类固醇的患者中没有发现低皮质醇症的迹象,这表明可以安全地省略它.
科学领域:
- 内分泌学 在内分泌学.
- 手术瘤学手术瘤学
- 内部医学 内部医学
背景情况:
- 库辛综合征 (CS) 通常通过手术治疗.
- 手术后的葡萄糖皮质激素替代是手术缓解后的标准.
- 在CS中进行外科手术期间葡萄糖皮质类药物治疗的必要性尚未得到充分证实.
研究的目的:
- 评估在内源性库辛综合征患者接受治疗性手术时的外科皮质醇治疗的作用.
- 为了确定中枢或上腺骨髓瘤患者的外科手术期间葡萄糖皮质激素替代是否至关重要.
主要方法:
- 一项研究包括预计进行治疗手术的中枢或上腺骨髓瘤患者和对照组.
- 患者在术后一天之前没有接受术前葡萄皮质类药物.
- 在多个时间点监测血清皮质醇水平:手术前,手术后,以及手术后的第一和第三天.
主要成果:
- 在CS患者中,33%和50%的血清皮质醇在术后第1天和第3天分别为5.0μg/dL.
- 没有患者表现出低皮质醇症的临床或生化迹象.
- 手术后皮质醇水平明显低于手术前水平 (p=0.023).
结论:
- 在接受治疗性手术的库辛综合征患者中,可以安全地省略术前葡萄糖皮质激素替代剂.
- 这种方法可能会简化CS患者的术后管理.
- 进一步的研究可能会证实在这种情况下不需要术后类固醇.
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