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[全身糖皮质激素治疗的代谢及心血管不良事件]

[Metabolic and cardiovascular adverse events of systemic glucocorticoid therapy].

作者信息

Fardet L

机构信息

Inserm UMR-S 938, service de médecine interne, faculté de médecine, université Pierre-et-Marie-Curie (UPMC) Paris 6, hôpital Saint-Antoine, AP-HP, 184, rue du Faubourg-Saint-Antoine, 75012 Paris, France.

出版信息

Rev Med Interne. 2013 May;34(5):303-9. doi: 10.1016/j.revmed.2012.12.005. Epub 2013 Jan 11.

Abstract

Diabetes, dyslipidemia, hypertension, weight gain, lipodystrophy and cardiovascular events are well-known adverse events of systemic glucocorticoid therapy. Despite their frequency and their life-threatening consequences, there are few, and sometimes discordant, available data. Incidence of and risk factors for dyslipidemia, weight gain and lipodystrophy are for instance imperfectly known. The optimal pharmacological management of patients with glucocorticoid-induced diabetes or hypertension is uncertain. Lastly, the strategies for screening and prevention of these adverse events depend on physicians' habits since no consensus is available. Some of these questions can be answered by looking at available data in patients with endogenous hypercorticism.

摘要

糖尿病、血脂异常、高血压、体重增加、脂肪营养不良和心血管事件是全身糖皮质激素治疗众所周知的不良事件。尽管这些不良事件很常见且会危及生命,但现有的数据却很少,有时甚至相互矛盾。例如,血脂异常、体重增加和脂肪营养不良的发生率及危险因素尚不完全清楚。糖皮质激素诱导的糖尿病或高血压患者的最佳药物治疗方案尚不明确。最后,由于尚未达成共识,这些不良事件的筛查和预防策略取决于医生的习惯。通过研究内源性皮质醇增多症患者的现有数据,可以回答其中一些问题。

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