Knowlton A I, Baer L
Am J Med. 1983 May;74(5):829-36. doi: 10.1016/0002-9343(83)91074-4.
In an average 30 years of follow-up study, seven of 22 patients with primary adrenal insufficiency have had cardiac failure. Comparison of these seven with the 15 who remain free of this complication revealed that the former group were somewhat older and had higher incidences of unrelated cardiac disease and of nonsteroid-dependent hypertension, but that their replacement regimens, with respect to sodium supplementation and sodium-retaining steroids, were identical with the latter. Coincident with the appearance of cardiac failure, all seven patients had a decrease in sodium requirements. Adequate control of the adrenal disease was subsequently possible with elimination of mineralocorticoid support in one of the six who had initially required this therapy and a reduction in dosage in the other five. In all seven, dietary sodium supplements were no longer required. In three patients with severe failure, sodium restriction was imposed and diuretics were added, although the latter therapy has required close monitoring to avoid sodium depletion.
在一项平均为期30年的随访研究中，22例原发性肾上腺皮质功能不全患者中有7例发生了心力衰竭。将这7例患者与15例未发生该并发症的患者进行比较发现，前一组患者年龄稍大，患无关心脏疾病和非类固醇依赖性高血压的发生率更高，但就钠补充和保钠类固醇而言，他们的替代治疗方案与后一组相同。与心力衰竭出现同时，所有7例患者的钠需求量均减少。随后，在最初需要这种治疗的6例患者中，有1例通过消除盐皮质激素支持实现了肾上腺疾病的充分控制，另外5例患者的剂量减少。在所有7例患者中，不再需要膳食钠补充剂。在3例严重心力衰竭患者中，实施了钠限制并加用了利尿剂，尽管后一种治疗需要密切监测以避免钠耗竭。
