| 危重症相关性皮质醇功能不全的诊断与治疗 |
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| 引用本文： | 罗彤枫,麦梨芳,张少玲,粱颖,林刁珠,郭颖,周晶,严励.危重症相关性皮质醇功能不全的诊断与治疗[J].中华临床医师杂志(电子版),2014(11):120-122. |
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| 作者姓名： | 罗彤枫 麦梨芳 张少玲 粱颖 林刁珠 郭颖 周晶 严励 |
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| 作者单位： | 中山大学孙逸仙纪念医院内分泌科,广州510120 |
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| 基金项目： | 广东省科技厅国际合作项目（20088050100010） |
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| 摘 要： | 近年来,危重症相关性皮质醇功能不全(CIRCI)成为新的研究热点。目前以基础皮质醇水平<10μg/dl和(或)大剂量促肾上腺皮质激素(ACTH)兴奋试验后Δmax<9μg/dl作为CIRCI的最佳诊断标准,但CIRCI的诊断和激素替代治疗的作用仍存在着很多争议。如何早期识别和准确诊断CIRCI并进行有效的治疗措施,依然是临床医师面临的重大挑战。本文就近年来CIRCI的诊断及激素治疗作用进行综述。
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| 关 键 词： | 危重病 肾上腺功能减退 糖皮质激素类 脓毒症 |
Diagnosis and therapy of critical illness-related corticosteroid insufficiency |
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| Luo Tongfeng,Mai Lifang,Zhang Shaoling,Liang Ying,Lin Diaozhu,Guo Ying,Zhou,ling,Yan Li.Diagnosis and therapy of critical illness-related corticosteroid insufficiency[J].Chinese Journal of Clinicians(Electronic Version),2014(11):120-122. |
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| Authors: | Luo Tongfeng Mai Lifang Zhang Shaoling Liang Ying Lin Diaozhu Guo Ying Zhou ling Yan Li |
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| Institution: | .( Department of Endocrinology, the Second Aliated Hospital, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guanghou 510120, China) |
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| Abstract: | Currently, there is a wide discussion about the critical illness-related corticosteroid insufficiency（CIRCI）. Although adrenal insufficiency in critical illness is best diagnosed by a random total cortisol of〈 10 μg/dl and/or a delta cortisol（after high-dose corticotropin stimulation test） of 〈9 μg/dl, the diagnosis of adrenal failure and the hormone replacement therapy in critically ill patients are controversial. It is a great challenge for the clinicians to make an accurate diagnosis and offer an effective treatment at this time. This paper reviewed the diagnostic criteria for CIRCI and the role of steroid therapy in critically ill patients |
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| Keywords: | Critical illness Adrenal insufficiency Glueocorticoids Sepsis |
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