儿科移植接受者的上腺功能不全
Hyunwoong Harry Chae1, Azim Ahmed1, Jeffrey N Bone2
1Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
Pediatric transplantation
|May 21, 2024
概括
接受皮质类固醇治疗的儿童移植患者面临上腺功能衰竭 (AI) 的显著风险,较高的类固醇剂量和排斥发作增加了这种风险. 早期检测和监测对于这些脆弱患者的AI管理至关重要.
科学领域:
- 儿科脏病学 儿科脏病学
- 内分泌学 在内分泌学.
- 移植医学 移植医学
背景情况:
- 儿童移植 (PKT) 接受者通常接受皮质类固醇以抑制免疫力.
- 长时间使用皮质类固醇与二次上腺功能衰竭 (AI) 有关,但其对PKT患者的具体影响尚未研究.
研究的目的:
- 评估PKT接受者的AI患病率.
- 识别与AI相关的风险因素.
- 为了确定AI在这个人群中的不良临床影响.
主要方法:
- 对PKT接受者的回顾性队列审查.
- 通过早晨皮质醇 (MC) 水平评估AI风险.
- 通过ACTH刺激测试证实了诊断.
- 分析与MC和AI诊断相关的风险因素和不良影响.
主要成果:
- 在51名PKT接受者中,AI在25.5%的患者中得到证实.
- 对AI的危险因素包括较高的普得尼松剂量,更长时间的暴露,每日服用和排斥发作.
- 较低的MC水平与增加的药物负担,住院治疗,肌素变异性和急性损伤相关.
结论:
- 增加的皮质类固醇暴露与较低的MC水平和PKT接受者的AI发病率较高有关.
- PKT患者的AI与更大的医疗复杂性和功能不稳定性有关.
- 建议在皮质类固醇治疗中接受PKT的患者进行AI的系统临床监测.
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