“相对性”肾上腺皮质功能不全再认识

Rethinking of Relative Adrenal Insufficiency

"相对性"肾上腺皮质功能不全(RAI)在危重病发病中起重要作用,临床上多应用促肾上腺皮质激素(ACTH)刺激试验来进行诊断。近年来研究发现,随机血清总皮质醇可用于临床诊断,而游离皮质醇水平则更有意义;美替拉酮及唾液皮质醇检测亦有应用前景。目前,ACTH刺激试验使用的剂量及RAI的诊断标准仍有不少争议。该文就近年来RAI相关的研究进展予以综述。

Relative adrenal insufficiency（RAI） plays an important role in the pathogenesis of critically ill patients,and adrenocorticotrophic hormone（ACTH） stimulation is used for the diagnosis of adrenal insufficiency.Recent studies show that the total cortisol concentrations in serum measured by random is helpful in the diagnosis of adrenal insufficiency,and measurement of free cortisol concentrations is more meaningful.The test of metyraponen and salivary cortisol concentration has good applicative prospect as well.Currently the dose of ACTH stimulation test and diagnostic criteria are still controversial.Here is to make a review of the recent research progress in RAI.