Oki Kenji, Yamane Kiminori
Hiroshima University, Department of Molecular and Internal Medicine, Graduate School of Biomedical Sciences, 1-2-3 Kasumi, Minami-ku, Hiroshima-City, Hiroshima 734-8551, Japan.
Expert Opin Pharmacother. 2007 Jun;8(9):1283-91. doi: 10.1517/14656566.8.9.1283.
Adrenal insufficiency is a life-threatening disorder. In the treatment of adrenal insufficiency, it is essential to administer the optimal medication at the optimal dose. Glucocorticoids are the main therapeutic approach in all forms of adrenal insufficiency. The recommended protocol for maintenance therapy is 15-25 mg of hydrocortisone, divided into two or three separate doses. Patients with primary adrenal insufficiency generally receive mineralocorticoid replacement comprised of fludrocortisone 0.05-0.2 mg/day. Recently, dehydroepiandrosterone has been proposed as a new therapeutic approach, despite the lack of strong evidence for beneficial effects. Additional glucocorticoid supplementation should be administered in stressful states. During critical illness, inadequate or no temporary increase in the dose of the replacement glucocorticoid can lead to acute adrenal failure. When acute adrenal failure occurs, it becomes necessary to administer intravenous hydrocortisone.
肾上腺功能不全是一种危及生命的疾病。在肾上腺功能不全的治疗中，以最佳剂量给予最佳药物至关重要。糖皮质激素是所有形式肾上腺功能不全的主要治疗方法。维持治疗的推荐方案是15 - 25毫克氢化可的松，分两到三次服用。原发性肾上腺功能不全患者通常接受盐皮质激素替代治疗，即每天服用0.05 - 0.2毫克氟氢可的松。最近，尽管缺乏有力的证据证明其有益效果，但脱氢表雄酮已被提议作为一种新的治疗方法。在应激状态下应额外补充糖皮质激素。在危重病期间，替代糖皮质激素剂量未充分增加或未临时增加可导致急性肾上腺功能衰竭。当发生急性肾上腺功能衰竭时，有必要静脉注射氢化可的松。
