Fischli Stefan
1 Abteilung Endokrinologie, Diabetologie und Klinische Ernährung, Departement Innere Medizin, Luzerner Kantonsspital.
Praxis (Bern 1994). 2018 Jun;107(13):717-725. doi: 10.1024/1661-8157/a002982.
Adrenal Insufficiency Abstract. Patients suffering from adrenal insufficiency (AI) often present with unspecific symptoms. Therefore, the diagnosis of AI, a potential life-threatening condition, can be missed. Lab tests, especially the ACTH-stimulation test, play a crucial role in the diagnosis of AI. According to the different etiologies, AI can be grouped into a primary (adrenal) or central (hypothalamic or pituitary, respectively) form. However, the most common cause is the treatment with glucocorticoids, which can lead to central AI. Patients suffering from AI are given hydrocortisone. The chronic replacement dose should be as low as possible, in acute situations, a rapid and sufficient increase of the hydrocortisone dose is necessary to prevent adrenal crisis. Replacement therapy with fludrocortisone is only necessary in patients with primary AI.
肾上腺功能不全摘要。肾上腺功能不全（AI）患者常表现出非特异性症状。因此，可能会漏诊AI这种潜在的危及生命的疾病。实验室检查，尤其是促肾上腺皮质激素（ACTH）刺激试验，在AI的诊断中起着关键作用。根据不同病因，AI可分为原发性（肾上腺性）或中枢性（分别为下丘脑性或垂体性）形式。然而，最常见的原因是糖皮质激素治疗，这可能导致中枢性AI。AI患者需服用氢化可的松。慢性替代剂量应尽可能低，在急性情况下，必须迅速充分增加氢化可的松剂量以预防肾上腺危象。仅原发性AI患者需要用氟氢可的松进行替代治疗。
