Meeking Susan
Animal Medical Center, 510 East 62nd Street, New York, NY 10021, USA.
Clin Tech Small Anim Pract. 2007 Feb;22(1):36-9. doi: 10.1053/j.ctsap.2007.02.006.
Hypoadrenocorticism is caused by a lack of endogenous glucocorticoid and mineralocorticoid. These deficiencies can cause a myriad of clinical signs. This disease is uncommon and its clinical presentation is similar to many much more commonly recognized diseases such as renal failure and various gastrointestinal disorders. Severely affected patients may present in a life-threatening adrenocortical crisis, which is characterized by variable degrees of volume depletion and electrolyte abnormalities. The emergency clinician should maintain a high clinical suspicion for hypoadrenocorticism, as early recognition and rapid treatment of hypovolemia and electrolyte abnormalities can be lifesaving. The approach to emergency treatment of hypoadrenocorticism should be to recognize and treat life-threatening arrhythmias, replace intravascular volume and normalize perfusion, correct electrolyte abnormalities and hypoglycemia, administer glucocorticoids, and perform the adrenocorticotrophic hormone stimulation test for definitive diagnosis. Patients with this condition should have a favorable outcome when treated appropriately.
肾上腺皮质功能减退症是由内源性糖皮质激素和盐皮质激素缺乏引起的。这些缺乏会导致无数的临床症状。这种疾病并不常见，其临床表现与许多更常见的疾病相似，如肾衰竭和各种胃肠道疾病。严重受影响的患者可能会出现危及生命的肾上腺皮质危象，其特征是不同程度的血容量减少和电解质异常。急诊医生应高度怀疑肾上腺皮质功能减退症，因为早期识别并快速治疗血容量不足和电解质异常可能会挽救生命。肾上腺皮质功能减退症的急诊治疗方法应是识别并治疗危及生命的心律失常、补充血管内容量并使灌注正常化、纠正电解质异常和低血糖、给予糖皮质激素，并进行促肾上腺皮质激素刺激试验以明确诊断。适当治疗后，患有这种疾病的患者应该会有良好的预后。
