Saito J, Nishikawa T
Department of Internal Medicine, Yokohama Rosai Hospital.
Nihon Rinsho. 1994 Mar;52(3):793-6.
Inhibitors of steroid synthesis such as o,p'-DDD, aminoglutethimide, metyrapone, trilostane and ketoconazole are usually used for treatment of Cushing's syndrome in order to reduce the steroid production in the patients showing several complications, including severe hypertension and diabetes mellitus, and also an incomplete remission after the surgical treatment. o,p'-DDD and metyrapone are recommended to use for treatment of adrenocortical cancer and rapid reduction of cortisol levels, respectively. Aminoglutethimide and trilostane do not always have any side effects, although ketoconazole which is commonly used for treatment of Cushing's disease shows severe hepatic damage. RU 486 is effective for inhibiting the activity of glucocorticoid receptor, and will be used for treatment of Cushing's syndrome in near future.
类固醇合成抑制剂,如邻对滴滴滴、氨鲁米特、美替拉酮、曲洛司坦和酮康唑,通常用于治疗库欣综合征,以减少出现多种并发症(包括严重高血压和糖尿病)且手术治疗后未完全缓解的患者的类固醇生成。邻对滴滴滴和美替拉酮分别被推荐用于治疗肾上腺皮质癌和快速降低皮质醇水平。氨鲁米特和曲洛司坦并非总是有副作用,尽管常用于治疗库欣病的酮康唑会导致严重肝损伤。RU 486可有效抑制糖皮质激素受体的活性,在不久的将来将用于治疗库欣综合征。