Schott Harold C
Department of Large Animal Clinical Sciences, D-202 Veterinary Medical Center, College of Veterinary Medicine, Michigan State University, East Lansing, MI 48824-1314, USA.
Vet Clin North Am Equine Pract. 2002 Aug;18(2):237-70. doi: 10.1016/s0749-0739(02)00018-4.
PPID in older equids has become a major health concern of horse owners. In response, equine practitioners have made greater efforts at understanding, diagnosing, and treating this disorder. Although PPID is recognized to be a different form of pituitary-dependent hyperadrenocorticism than is seen in canine or human patients, relatively little is known about the pathophysiology and natural progression of the disease. At present, the diagnosis is best supported by manifestation of characteristic clinical signs and endocrinologic test results, preferably a supportive DST result. Treatment must focus on improving overall health care, including body clipping, dentistry, and nutrition. As the condition progresses, administration of pergolide or a combination of pergolide and cyproheptadine is currently considered the best medical treatment. The time point at which medication should be added to improved health care and management changes is not currently known, but loss of body condition and development of hyperglycemia suggest more advanced PPID that would likely benefit from drug therapy. Whether medical treatment needs to be continuous or could be intermittent is also unknown. As the demand for treatment of affected equids continues to increase, clinical response and endocrinologic testing data as well as pharmacologic data for currently used drugs and other agents should be expected. Similarly, novel medical, and perhaps surgical, treatment strategies for this condition should also be anticipated in the future.
老年马属动物的垂体 pars intermedia 功能亢进（PPID）已成为马主们主要关注的健康问题。对此，马医在了解、诊断和治疗这种疾病方面付出了更多努力。尽管人们认识到 PPID 是一种与犬类或人类患者所见的垂体依赖性肾上腺皮质功能亢进不同的形式，但对该疾病的病理生理学和自然发展过程了解相对较少。目前，诊断最好通过特征性临床症状的表现和内分泌测试结果来支持，最好是支持性的地塞米松抑制试验（DST）结果。治疗必须侧重于改善整体医疗护理，包括剪毛、牙科护理和营养。随着病情进展，目前认为给予培高利特或培高利特与赛庚啶的组合是最佳药物治疗方法。目前尚不清楚应在何时将药物添加到改善健康护理和管理措施中，但身体状况下降和高血糖的出现表明 PPID 病情更严重，可能会从药物治疗中受益。药物治疗是需要持续进行还是可以间歇性进行也尚不清楚。随着对患病马属动物治疗需求的持续增加，预计会有临床反应和内分泌测试数据以及目前使用药物和其他药剂的药理学数据。同样，未来也应预期针对这种情况的新型药物治疗，甚至手术治疗策略。
