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J Clin Endocr Metab:内分泌学会发布了“原发性肾上腺皮质功能不全”的临床实践指南

2016-01-14 Mechront 译 MedSci原创

内分泌学会发布了原发性肾上腺皮质功能不全(阿狄森氏病)诊断和治疗的临床实践指南(CPG)。原发性肾上腺皮质功能不全是一种罕见的、可危及生命的疾病,患该疾病时,身体皮质醇激素分泌减少。肾上腺分泌的皮质醇激素与机体压力、血压、心血管功能、免疫系统等有关,此外还能将脂肪、碳水化合物和蛋白质转化为能量。出现原发性肾上腺皮质功能不全时,患者可能会出现体重减轻、疲劳、肌肉无力、食欲下降、恶心呕吐、腹泻等症状。

内分泌学会发布了原发性肾上腺皮质功能不全(阿狄森氏病)诊断和治疗的临床实践指南(CPG)。

原发性肾上腺皮质功能不全是一种罕见的、可危及生命的疾病,患该疾病时,身体皮质醇激素分泌减少。肾上腺分泌的皮质醇激素与机体压力、血压、心血管功能、免疫系统等有关,此外还能将脂肪、碳水化合物和蛋白质转化为能量。出现原发性肾上腺皮质功能不全时,患者可能会出现体重减轻、疲劳、肌肉无力、食欲下降、恶心呕吐、腹泻等症状。

原发性肾上腺皮质功能不全的多种症状与许多健康问题相关,该疾病的诊断仍具有挑战性。如果不能早诊断、早治疗该疾病,后果很严重,死亡风险会增加,并且部分严重症状需要即刻处理。

内分泌学会建议对不明原因的症状进行诊断性试验,以排除原发性肾上腺皮质功能不全的病人。有严重症状或肾上腺危象的患者应立即接受药物治疗,直至诊断明确。医生应在患者条件允许的情况下,进行促肾上腺皮质激素刺激试验来确定诊断。

CPG其他要点:
  • 抽血检查评估患者促肾上腺皮质激素(ACTH)水平,以建立原发性肾上腺功能不全的诊断;
  • 还要检查患者血液中肾素和醛固酮水平,以明确患者是否存在调节水盐平衡的激素的缺乏;
  • 对明确诊断为原发性肾上腺功能不全的患者使用氢化可的松进行糖皮质激素替代治疗;
  • 患有原发性肾上腺功能不全和醛固酮缺乏症的患者,常使用合成的皮质醇激素进行替代治疗,维持机体水盐平衡,接受该治疗的患者应随访电解质情况,注意头晕、血压变化和腿脚肿胀等缺盐症状。
原始出处:

Stefan R. Bornstein(chair),et al.Diagnosis and Treatment of Primary Adrenal Insufficiency: An Endocrine Society Clinical Practice Guideline.Journal of Clinical Endocrinology & Metabolism.January 13, 2016

Experts recommend immediate treatment for severe primary adrenal insufficiency symptoms.MedicalNewsToday.2016

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    2016-04-04 gwc392
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    2016-09-20 guojianrong
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    2016-04-22 忠诚向上

    值得学习

    0

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    2016-04-22 忠诚向上

    值得学习

    0

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    2016-04-22 忠诚向上

    值得学习

    0

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    2016-04-22 忠诚向上

    值得学习

    0

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