在上腺衰竭中持续的皮下皮注:在33名患者的实践经验
Jane Lee1, Oksana Hamidi1, Emily Simon1
1University of Texas Southwestern Medical Center, Division of Endocrinology and Metabolism, Dallas, Texas.
概括
持续的皮下皮注 (CSHI) 提供了一种安全有效的方法来管理上腺功能缺陷 (AI),通过提供个性化的葡萄糖皮质激素治疗. 这种方法减少了急诊和住院的次数,改善了患者的治疗结果和偏好.
科学领域:
- 内分泌学 在内分泌学.
- 药理学 药理学是指药理学的学科.
- 患者护理 患者护理
背景情况:
- 患有上腺功能衰竭 (pwAI) 的人经常经历健康状况不佳和标准口服葡萄糖皮质激素治疗的死亡率增加.
- 与口服方法相比,连续皮下皮注 (CSHI) 提供了更生理性的皮质醇输送.
- 关于CSHI患者选择,最佳剂量和临床结果的数据有限.
研究的目的:
- 评估CSHI在有持续症状的 pwAI 中的安全性和有效性.
- 评估CSHI启动后临床结果的变化,包括急诊,住院和健康状况的变化.
- 为了确定患者的偏好和CSHI治疗的耐受性.
主要方法:
- 进行了一项单一中心的回顾性纵向队列研究.
- 33名连续的pwAI经历了持续的AI症状,被提供了CSHI的治疗试验.
- 在CSHI启动之前和之后,分析了临床结果和患者偏好.
主要成果:
- 转换为CSHI后,每日葡萄糖皮质体剂量的中位数显著下降.
- 由于上腺危机,CSHI导致急诊室访问和住院的数量大幅减少.
- 主观健康评分显示数字上升,大多数患者 (84.8%) 倾向于继续CSHI.
结论:
- 在 pwAI 中,CSHI 是个性化葡萄糖皮质激素替代的安全有效的治疗选择.
- 通过减少上腺危机相关的医疗保健利用,CSHI可以改善临床结果.
- 患者的偏好和耐受性支持使用CSHI来治疗上腺功能不全.
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