肾上腺危象处理

Management of adrenal crisis

数十年来,肾上腺危象均被模糊描述为一组具有危重表现的综合征。因此导致"肾上腺危象"发生率、病死率、治疗等一系列研究的一致性差,缺乏共识。直至2015年,英国的医师推荐了一个诊断方法,虽然仍不完善,但可令临床医师应用时有所参考。肾上腺功能不全这类疾病都有可能在某些因素的打击下诱发危象。认识到它的凶险,教育好如何识别和处理肾上腺危象至关重要。先天性肾上腺皮质增生是儿童肾上腺危象的主要原发疾病,对其治疗还需要进一步研究。因小剂量疗法和速效制剂自应用以来危象的发生是增加的。目前还缺乏很好的证据。

Adrenal crisis （AC） is the term of a syndrome which has been used to describe a group of critical symptoms in rather unclear words for decades. It has brought a poor concordance on the data of mortality, morbidity and treatment among researches, and it has also hindered researchers to reach consensus till 2015, when the adrenal crisis criteria was proposed by a British phy- sician. While it is still not perfect, it does give physicians a ref- erence in clinical practice. The author considers it a meaningful step forward. Adrenal insufficiency could be turned into adrenal crisis with any stress. Being aware of the threat of AC and edu- cating people of its symptoms and treatment are essential for both the patients and their care givers. CAH is the most common disease for AC in pediatrics and the therapy should he further researched because the morbidity of AC has increased since the regime of short-acting tablets and small doses. Perfect evidence is still absent at present.