Therapeutic strategies in adrenal insufficiency.
Therapeutic strategies in adrenal insufficiency.
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肾上腺功能不全的治疗策略。
DOI：
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发表时间：
2001
期刊：
影响因子：
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通讯作者：
V. Bähr
中科院分区：
文献类型：
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作者：
W. Oelkers;S. Diederich;V. Bähr
严重的慢性肾上腺功能不全(原发性或继发性)是一种潜在的致命疾病，除非患者经常服用糖皮质激素，通常在患有原发性肾上腺疾病(Addison病)的患者中使用氢化可的松(15-25毫克/天)和9α-氟氢化可的松(0.05-0.2毫克/天)。在紧张和发烧的情况下，必须预防性增加糖皮质激素的剂量，以防止“肾上腺危象”。大多数肾上腺功能不全的女性将受益于脱氢表雄酮(DHEA)在幸福感和性功能方面的额外替代。如果漏诊，不立即开始大剂量糖皮质激素治疗，急性肾上腺功能不全患者将死亡。重症监护患者(如肾上腺出血或肾上腺静脉血栓形成)发生急性肾上腺功能不全是最具挑战性的诊断。然而，在这些患者中，生存不仅取决于糖皮质激素的替代，还取决于潜在的疾病。
Severe chronic adrenal insufficiency (primary or secondary) is a potentially lethal disorder, unless the patient is regularly substituted with glucocorticoids, usually with hydrocortisone (15-25 mg/day) and with 9 alpha-fluor-hydrocortisone (0.05-0.2 mg/day) in addition in patients with the primary adrenal disorder (Addison's disease). In stressful situations and in febrile disorders, the glucocorticoid dosage must be increased prophylactically in order to prevent an "adrenal crisis". Most women with adrenal insufficiency will profit from the additional substitution of dehydroepiandrosterone (DHEA) with regard to well-being and sexual function. A patient with acute adrenal insufficiency will die if the diagnosis is missed and high-dose glucocorticoid treatment is not instituted immediately. Acute adrenal insufficiency developing de novo in an intensive care patient (e.g. from adrenal hemorrhage or adrenal vein thrombosis) is a most challenging diagnosis. In these patients, however, survival not only depends on glucocorticoid substitution but also on the underlying disease.