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皮质类固醇的临床应用及特性

Clinical use and characteristics of the corticosteroids.

作者信息

Harkins J D, Carney J M, Tobin T

机构信息

Maxwell H. Gluck Equine Research Center, Department of Veterinary Science, University of Kentucky, Lexington.

出版信息

Vet Clin North Am Equine Pract. 1993 Dec;9(3):543-62. doi: 10.1016/s0749-0739(17)30385-1.

Abstract

Corticosteroids possess potent anti-inflammatory activity and are commonly injected intra-articularly for local relief of inflammatory lesions in performance horses. However, the suppression of anabolic activity in the joint may lead to an increased rate of joint breakdown. Complications associated with intra-articular corticosteroid therapy include septic arthritis, which is usually due to inadvertent joint contamination at the time of corticosteroid injection, and steroid arthropathy, which is characterized by an accelerated rate of joint destruction and radiographic evidence of severe degenerative joint disease. Prognosis for both of these conditions is poor. Adverse effects of systemic corticosteroid therapy includes suppression of the hypothalamic-pituitary adrenal system, increased susceptibility to infection, and laminitis; however, moderate use of glucocorticoids does not permanently affect adrenal function.

摘要

皮质类固醇具有强大的抗炎活性,常用于给竞技马匹关节内注射以局部缓解炎症性病变。然而,关节合成代谢活性的抑制可能会导致关节破坏率增加。关节内皮质类固醇治疗相关的并发症包括化脓性关节炎,这通常是由于皮质类固醇注射时意外的关节污染所致,以及类固醇性关节病,其特征是关节破坏加速和严重退行性关节病的影像学证据。这两种情况的预后都很差。全身皮质类固醇治疗的不良反应包括下丘脑-垂体-肾上腺系统的抑制、感染易感性增加和蹄叶炎;然而,适度使用糖皮质激素不会永久性影响肾上腺功能。

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