Drake W M, Perry L A, Hinds C J, Lowe D G, Reznek R H, Besser G M
Department of Endocrinology, St. Bartholomew's Hospital, London, United Kingdom.
J Clin Endocrinol Metab. 1998 Oct;83(10):3542-4. doi: 10.1210/jcem.83.10.5156.
We report the emergency and prolonged use of etomidate to control circulating cortisol levels in a patient with Cushing's syndrome secondary to ectopic ACTH production from a pancreatic islet cell tumor. Duodenal perforation and peritonitis complicated an episode of salmonella septicemia, precluding the use of conventional oral medical adrenolytic therapy. Endogenous cortisol secretion was abolished by parenteral etomidate, allowing serum cortisol levels to be controlled with an iv infusion of hydrocortisone over an 8-week period in intensive care before definitive pancreatic surgery.
我们报告了在一名因胰岛细胞瘤产生异位促肾上腺皮质激素（ACTH）继发库欣综合征的患者中，使用依托咪酯进行紧急和长期治疗以控制循环皮质醇水平的情况。十二指肠穿孔和腹膜炎并发沙门氏菌败血症，排除了使用传统口服肾上腺溶解疗法的可能性。通过胃肠外给予依托咪酯消除了内源性皮质醇分泌，从而在重症监护下进行明确的胰腺手术前的8周内，通过静脉输注氢化可的松来控制血清皮质醇水平。
