肾上腺 机能不全
Overview
肾上腺, 位于肾脏上方, secrete many hormones essential for the body's normal functions. People with adrenal insufficiency do not produce enough of two vital hormones, 叫做皮质醇和醛固酮. Cortisol's most important function is to help the body respond to stress, 比如手术和疾病, 从感染中恢复. The hormone also helps maintain blood pressure and cardiovascular functions and regulate the metabolism of proteins, 碳水化合物和脂肪. 醛固酮调节盐的含量, 体内的钾和水, 保持适当的平衡.
Men and women of all ages are equally affected by adrenal insufficiency, which may be permanent or temporary and can be treated with medications. Causes of the permanent form of the condition include Addison's disease, 先天性肾上腺增生, complete surgical removal of the pituitary gland or the adrenal glands. Temporary adrenal insufficiency can be caused by physical stress, 感染, 手术或没有服用正确的药物.
我们治疗肾上腺功能不全的方法
UCSF is an international leader in 内分泌学 care. 我们的团队提供全面的咨询, evaluations and treatments for a wide range of adrenal hormone disorders, 如肾上腺功能不全.
We can effectively manage adrenal insufficiency using medications that replace hormones the body isn't producing. Proper treatment should allow patients to enjoy an active lifestyle with normal life expectancy. 和大多数慢性疾病一样, treating adrenal insufficiency requires that patients take responsibility for some aspects of their care, 比如戴上医疗警报手环, following dietary recommendations and staying in contact with their health care team.
奖 & 识别
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是全国顶尖的十大赌博平台排行榜之一
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全国最好的糖尿病治疗中心之一 & 内分泌学
迹象 & 症状
The 症状 of adrenal insufficiency usually begin gradually. 早期症状可能包括:
- 异常疲劳和肌肉无力
- 站立时头晕
- 恶心、呕吐和/或腹泻
- 食欲不振
- 胃痛
Symptoms that may occur in the later stages of the disease include:
- 减肥
- 晒黑:皮肤晒黑
- 想吃盐
诊断
肾上腺 insufficiency can be difficult to diagnose. Your doctor will begin by asking about your medical history and about any obvious 症状 you are experiencing. Tests that measure the levels of cortisol and aldosterone are used to make a definite diagnosis and include the following:
- ACTH刺激试验. This is the most specific test for diagnosing adrenal insufficiency. Blood cortisol levels are measured before and after a synthetic form of adrenocorticotrophic hormone (ACTH), 垂体激素垂体前叶分泌的激素, 注射给药.
- 胰岛素诱导低血糖试验. The insulin-induced hypoglycemia test is used to determine how the hypothalamus, 垂体和肾上腺会对压力做出反应. 在这个测试中, blood is drawn to measure the blood glucose and cortisol levels, 然后注射速效胰岛素. Blood glucose and cortisol levels are measured again 30, 注射胰岛素后45和90分钟. The normal response is for blood glucose levels to fall (this represents the stress) and cortisol levels to rise.
Once a diagnosis of adrenal insufficiency has been made, a computed tomography (CT) scan of the abdomen may be taken to see if the adrenal glands are diminished in size, 反映破坏, 或扩大, reflecting infiltration by some independent disease process. 扫描也可能显示钙沉积的迹象, which may indicate previous exposure to tuberculosis. A tuberculin skin test may be used to address the latter possibility.
A number of imaging tools may be used to examine the size and shape of the pituitary gland. The most common is the magnetic resonance imaging (MRI) scan, which produces a series of images that provide a cross-sectional picture of the pituitary and the area of the brain that surrounds it.
In addition, the function of the pituitary and its ability to produce other hormones are tested. 通常, measurements of ACTH — the pituitary hormone most relevant for maintenance of normal adrenal function — along with thyroid stimulating hormone (TSH), 促卵泡激素(FSH), luteinizing hormone (LH) and prolactin are made under resting conditions and following provocative simulation, such as following the administration of corticotrophin releasing hormone (CRH), which leads to an increase in ACTH levels under normal conditions.
治疗
肾上腺 insufficiency results in a lack of essential hormones, and therefore treatment focuses on replacing or substituting those hormones. Cortisol is replaced orally with tablets taken once or twice a day. Aldosterone is replaced with oral doses of a mineralocorticoid, 叫做醋酸氟可的松, 每天服用一次. Fludrocortisone helps to maintain the right levels of salt and fluids in the body.
加州大学旧金山分校健康 medical specialists have reviewed this information. It is for educational purposes only and is not intended to replace the advice of your doctor or other health care provider. We encourage you to discuss any questions or concerns you may have with your provider.
