促肾上腺皮质激素缺乏——长期糖皮质激素疗法矫正低钠血症和醛固酮过少症

• 作 者: G.RWerriamandLBaer 孟庆余
• 出 处: 牡丹江医专学报
• 发表日期: 1980年S1期
• 关键词: 低钠血症 醛固酮 垂体机能减退 机能不全 肾素 肾上腺 反应性异常 水潴留 糖皮质激素 限钠

自从1954年,Steinerg等报告第一例选择性促肾上腺皮质激素(ACTH)缺乏综合征以来,至今大约已报导了25例。其病因尚不清楚。全垂体机能减退或单一ACTH缺乏的病例比原发性肾上腺机能不全,更少发生严重的低钠血症。如不限制钠盐,多数这种病例并不发生明显的电解质紊乱。此时,低钠血症也许是由于过多的水潴留或者由于醛固酮反应迟钝,使钠丧失。

Since Steinerg et al reported the first case of ACTH deficiency syndrome in 1954, about 25 cases have been reported to date. The etiology is not clear. Pituitary dysfunction or a single ACTH deficiency cases than the primary adrenal insufficiency, less severe hyponatremia. Without limiting the sodium salt, most of these cases did not occur obvious electrolyte imbalance. At this point, hyponatremia may be due to excessive water retention or loss of sodium due to the slow response of aldosterone.