Department of Endocrinology, Assistance Publique-Hopitaux de Marseille, INSERM, Marseille Medical Genetics, Marmara Institute, French Reference Center for Rare Pituitary Diseases, Endo-European Reference Network and EURACAN European Expert Center on Rare Pituitary Tumors, La Conception Hospital, Aix Marseille University, 147 Boulevard Baille, 13385, Marseille Cedex 05, France.
Pituitary. 2022 Oct;25(5):737-739. doi: 10.1007/s11102-022-01244-w. Epub 2022 Jul 2.
Transsphenoidal surgery is the first-line treatment for Cushing's disease. However, some situations may require the use of a primary medical treatment, such as in patients with severe life-threatening hypercortisolism, a situation which can be handled by fast-acting steroidogenesis inhibitors, instead of classical bilateral adrenalectomy. Primary medical treatment could also be considered in patients with non-severe hypercortisolism, but the evidence is far less convincing for its systematic use. The aim of this short review is to explain briefly the different circumstances in which primary medical therapy could be considered, the limits of this approach, and the way in which to initiate and monitor the treatment.
经蝶窦手术是库欣病的一线治疗方法。然而，在某些情况下可能需要采用主要的药物治疗，例如在有严重危及生命的皮质醇增多症的患者中，可以使用快速作用的类固醇生成抑制剂，而不是经典的双侧肾上腺切除术。对于非严重皮质醇增多症的患者也可以考虑采用主要的药物治疗，但系统使用这种方法的证据还远不充分。本文的目的是简要解释可以考虑采用主要药物治疗的不同情况、这种方法的局限性，以及如何开始和监测治疗。
