摘要
目的探讨不同剂量糖皮质激素替代治疗对腺垂体功能减退症患者激素暴露的影响。方法回顾性分析2018年10月至2021年10月间于濮阳市中医医院就诊的72例腺垂体功能减退症患者临床资料,根据不同用药剂量分为低剂量组(27例)、正常剂量组(24例)和高剂量组(21例)。比较3组患者糖化血红蛋白、空腹血糖、钾离子、钠离子、尿酸、舒张压、收缩压、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇及总胆固醇各项临床指标数据;将3组糖尿病、高血压病、血脂异常、慢性胃炎、非酒精性脂肪肝、冠心病、向心性肥胖、精神症状发生情况进行比较;比较3组患者治疗前后的躯体功能、生理功能、健康状态、认知功能、社会功能、角色功能。结果3组患者糖化血红蛋白、空腹血糖、钾离子、钠离子、尿酸水平比较均差异无统计学意义(P均>0.05);高剂量组患者舒张压、收缩压及低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、总胆固醇水平均高于低剂量组与正常剂量组(P均<0.05)。高剂量组发生高血压病、血脂异常、慢性胃炎、非酒精性脂肪肝病、冠心病、向心性肥胖、精神症状患者的占比高于低剂量组与正常剂量组(P均<0.05)。3组患者治疗后生存质量均有所提升,低剂量组患者健康状态优于正常剂量组与高剂量组患者(P<0.05)。3组躯体功能、生理功能、认知功能、社会功能及角色功能比较均差异无统计学意义(P均>0.05)。结论腺垂体功能减退症患者采用不同剂量糖皮质激素的个性化代替治疗对其激素暴露的影响程度也有所不同,治疗过程中需监测患者血脂、血糖变化,低剂量的糖皮质激素替代疗法可有效降低患者激素暴露的风险,临床可根据患者不同症状进行个体化给药治疗,提高患者生存质量。
Objective To explore the effect of different doses of glucocorticoid replacement therapy on hormone exposure in patients with pituitary insufficiency.Methods A retrospective analysis was conducted on the clinical data of 72 patients with pituitary insufficiency who visited Puyang Traditional Chinese Medicine Hospital from October 2018 to October 2021.They were divided into low-dose group(27 cases),normal dose group(24 cases),and high-dose group(21 cases)based on different drug doses.The clinical indicators of glycated hemoglobin,fasting blood glucose,potassium ions,sodium ions,uric acid,diastolic blood pressure,systolic blood pressure,low-density lipoprotein cholesterol,high-density lipoprotein cholesterol,and total cholesterol were compared among three groups of patients.The incidence of diabetes,hypertension,dyslipidemia,chronic gastritis,nonalcoholic fatty liver,coronary heart disease,centripetal obesity,and mental symptoms in the three groups were compared.The physical function,physiological function,health status,cognitive function,social function,and role function of three groups of patients before and after treatment were compared.Results There were no significant differences in glycosylated hemoglobin,fasting blood glucose,potassium ions,sodium ions,and uric acid levels among the three groups of patients(P>0.05).The diastolic blood pressure,systolic blood pressure,low-density lipoprotein cholesterol,high-density lipoprotein cholesterol,and total cholesterol levels in the high-dose group were significantly higher than those in the low-dose group and the normal-dose group(P<0.05).The proportion of patients with hypertension,dyslipidemia,chronic gastritis,non-alcoholic fatty liver disease,coronary heart disease,central obesity,and psychiatric symptoms in the high-dose group was significantly higher than that in the low-dose group and the normal-dose group(P<0.05).The quality of life of all three groups of patients improved after treatment,and the health status of patients in the low-dose group was significan
作者
白慧利
Bai Huili(Department of Pharmacy,Puyang Traditional Chinese Medicine Hospital,Puyang,Henan 457000,China)
出处
《中国药物与临床》
CAS
2024年第4期226-230,共5页
Chinese Remedies & Clinics
