肾上腺皮质功能不全与代谢危象及猝死

Relationship of adrenal insufficiency with metabolic crisis and sudden death

肾上腺皮质功能不全是一类由原发或继发因素引起的肾上腺皮质激素分泌不足的疾病。由于其临床表现缺乏特异性,不易早期识别,可导致诊断延迟,若治疗不及时会引发肾上腺危象甚至发生猝死。由肾上腺皮质功能不全引起的患儿猝死可能与肾上腺危象导致的高钾血症直接相关。胃肠疾病及感染等是肾上腺危象的常见诱因。尽管其是一种可治疗的疾病,但若未进行适当的预防或延误治疗往往导致不必要的死亡。因此,需要制定更多措施来预防肾上腺危象,并确保在危象发生后采取恰当的急救方案,以减少猝死。

Adrenal insufficiency(AI)is a type of adrenocortical hormone-deficient lesion caused by primary or secondary factors. Because of its lack of specificity in clinical manifestations,it is difficult to identify early,which may lead to delayed diagnosis. If the treatment is not timely,it may cause adrenal crisis(AC)or even sudden death. Sudden death in children due to adrenal insufficiency may be directly related to hyperkalemia caused by adrenal crisis. Gastrointestinal illness and infections are common precipitant for an adrenal crisis. Despite it being a treatable condition for now,failure of adequate preventive measures or delayed treatment has often led to unnecessary deaths. Therefore,more measures are needed to prevent the adrenal crisis and to ensure that appropriate emergency medical services are established after the crisis to reduce the rate of sudden death.