切换至 "中华医学电子期刊资源库"

中华产科急救电子杂志 ›› 2024, Vol. 13 ›› Issue (01) : 6 -12. doi: 10.3877/cma.j.issn.2095-3259.2024.01.002

妊娠合并内分泌疾病

妊娠合并肾上腺皮质功能减退症的诊治
邹童1, 姚强1,()   
  1. 1. 610041 成都,四川大学华西第二医院产科
  • 收稿日期:2023-08-01 出版日期:2024-02-18
  • 通信作者: 姚强
  • 基金资助:
    四川省科技厅项目(2022JDKP0008)

Diagnosis and treatment of pregnancy complicated with adrenal insufficiency

Tong Zou, Qiang Yao()   

  • Received:2023-08-01 Published:2024-02-18
  • Corresponding author: Qiang Yao
引用本文:

邹童, 姚强. 妊娠合并肾上腺皮质功能减退症的诊治[J]. 中华产科急救电子杂志, 2024, 13(01): 6-12.

Tong Zou, Qiang Yao. Diagnosis and treatment of pregnancy complicated with adrenal insufficiency[J]. Chinese Journal of Obstetric Emergency(Electronic Edition), 2024, 13(01): 6-12.

妊娠合并肾上腺皮质功能减退症较为罕见,很多产科医生在诊治此类疾病上经验有限,因此如何及时诊断并规范管理患有肾上腺皮质减退症的孕妇具有较大的挑战。本文围绕妊娠合并肾上腺功能减退症的诊治、妊娠结局、母乳喂养及患者教育等方面进行论述。

Pregnancy complicated with adrenal insufficiency is rare in clinical practice. Many obstetricians have limited experience in dealing with such diseases, and this poses a great challenge to early diagnosis and standardized treatment of pregnant women with such kind of diseases. This article focuses on the diagnosis and treatment, pregnancy outcomes, perinatal management, breastfeeding, and patient education of pregnancy complicated with adrenal insufficiency.

[1]
Husebye ES, Pearce SH, Krone NP, et al. Adrenal insufficiency[J]. Lancet (London, England)2021397(10274):613-629.
[2]
中华医学会内分泌学分会肥胖学组. 肾上腺皮质功能减退症患者围手术期糖皮质激素管理专家共识[J]. 中华内分泌代谢杂志202238(1):1-6.
[3]
Eaton WW, Rose NR, Kalaydjian A, et al. Epidemiology of autoimmune diseases in Denmark[J]. J Autoimmun200729(1):1-9.
[4]
LøVåS K, Husebye ES. High prevalence and increasing incidence of Addison′s disease in western Norway[J]. Clin Endocrinol200256(6):787-791.
[5]
Olafsson AS, Sigurjonsdottir HA. Increasing prevalence of Addison disease: results from a nationwide study[J]. Endocr Pract201622(1):30-35.
[6]
Laureti S, Vecchi L, Santeusanio F, et al. Is the prevalence of Addison′s disease underestimated?[J]. J Clin Endocrinol Metab199984(5):1-5.
[7]
Hong AR, Ryu OH, Kim SY, et al. Characteristics of Korean patients with primary adrenal insufficiency: a registry-based nationwide survey in Korea[J]. Endocrinol Metab (Seoul)201732(4):466-474.
[8]
Takayanagi R, Miura K, Nakagawa H, et al. Epidemiologic study of adrenal gland disorders in Japan[J]. Biomed Pharmacother200054 Suppl 1:164s-168s.
[9]
Calina D, Docea AO, Golokhvast KS, et al. Management of endocrinopathies in pregnancy: a review of current evidence[J]. Int J Environ Res Public Health201916(5):1-25.
[10]
Schneiderman M, Czuzoj-Shulman N, Spence AR, et al. Maternal and neonatal outcomes of pregnancies in women with Addison′s disease: a population-based cohort study on 7.7 million births[J]. BJOG2017124(11):1772-1779.
[11]
Langlois F, Lim DST, Fleseriu M. Update on adrenal insufficiency: diagnosis and management in pregnancy[J]. Curr Opin Endocrinol Diabetes Obes201724(3):184-192.
[12]
Woodcock T, Barker P, Daniel S, et al. Guidelines for the management of glucocorticoids during the peri-operative period for patients with adrenal insufficiency: guidelines from the Association of Anaesthetists, the Royal College of Physicians and the Society for Endocrinology UK[J]. Anaesthesia202075(5):654-663.
[13]
Carr BR, Parker CR Jr, Madden JD, et al. Maternal plasma adrenocorticotropin and cortisol relationships throughout human pregnancy[J]. Am J Obstet Gynecol1981139(4):416-422.
[14]
Anand G, Beuschlein F. Management of endocrine disease: fertility, pregnancy and lactation in women with adrenal insufficiency[J]. Eur J Endocrinol2018178(2):R45-53.
[15]
Frise CJ, Williamson C. Endocrine disease in pregnancy[J]. Clin Med (Lond)201313(2):176-181.
[16]
Motosko CC, Bieber AK, Pomeranz MK, et al. Physiologic changes of pregnancy: a review of the literature[J]. Int J Womens Dermatol20173(4):219-224.
[17]
Richardson BS, Wakim E, Dasilva O, et al. Preterm histologic chorioamnionitis: impact on cord gas and pH values and neonatal outcome[J]. Am J Obstet Gynecol2006195(5):1357-1365.
[18]
Manoharan M, Sinha P, Sibtain S. Adrenal disorders in pregnancy, labour and postpartum - an overview[J]. J Obstet Gynaecol202040(6):749-758.
[19]
Gjerstad JK, Lightman SL, Spiga F. Role of glucocorticoid negative feedback in the regulation of HPA axis pulsatility[J]. Stress201821(5):403-416.
[20]
Bornstein SR, Allolio B, Arlt W, et al. Diagnosis and treatment of primary adrenal insufficiency: an Endocrine Society clinical practice guideline[J]. J Clin Endocrinol Metab2016101(2):364-389.
[21]
Fleseriu M, Hashim IA, Karavitaki N, et al. Hormonal replacement in hypopituitarism in adults: an Endocrine Society clinical practice guideline[J]. J Clin Endocrinol Metab2016101(11):3888-3921.
[22]
Yanase T, Tajima T, Katabami T, et al. Diagnosis and treatment of adrenal insufficiency including adrenal crisis: a Japan Endocrine Society clinical practice guideline [Opinion][J]. Endocr J201663(9):765-784.
[23]
Suri D, Moran J, Hibbard JU, et al. Assessment of adrenal reserve in pregnancy: defining the normal response to the adrenocorticotropin stimulation test[J]. J Clin Endocrinol Metab200691(10):3866-3872.
[24]
Bancos I, Hahner S, Tomlinson J, et al. Diagnosis and management of adrenal insufficiency[J]. Lancet Diabetes Endocrinol20153(3):216-226.
[25]
Shrivastava S, Chen B, Dworkin LD, et al. Relapse of Nephrotic Syndrome after adrenocorticotropic hormone-induced remission: implications of adrenocorticotropic hormone antibodies[J]. Am J Nephrol202051(5):390-394.
[26]
陈家伦. 临床内分泌学[M]. 上海:上海科学技术出版社,2011:549-554.
[27]
Schmidt IL, Lahner H, Mann K, et al. Diagnosis of adrenal insufficiency: evaluation of the corticotropin-releasing hormone test and Basal serum cortisol in comparison to the insulin tolerance test in patients with hypothalamic-pituitary-adrenal disease[J]. J Clin Endocrinol Metab200388(9):4193-4198.
[28]
Lebbe M, Arlt W. What is the best diagnostic and therapeutic management strategy for an Addison patient during pregnancy?[J]. Clin Endocrinol201378(4):497-502.
[29]
葛均波,徐永健. 内科学[M]. 9版.北京:人民卫生出版社,2018:713-715.
[30]
Arlt W, Callies F, Van Vlijmen JC, et al. Dehydroepiandrosterone replacement in women with adrenal insufficiency[J]. N Engl J Med1999341(14):1013-1020.
[31]
Wierman ME, Arlt W, Basson R, et al. Androgen therapy in women: a reappraisal: an Endocrine Society clinical practice guideline[J]. J Clin Endocrinol Metab201499(10):3489-3510.
[32]
Esteban NV, Loughlin T, Yergey AL, et al. Daily cortisol production rate in man determined by stable isotope dilution/mass spectrometry[J]. J Clin Endocrinol Metab199172(1):39-45.
[33]
Plat L, Leproult R, L′Hermite-Baleriaux M, et al. Metabolic effects of short-term elevations of plasma cortisol are more pronounced in the evening than in the morning[J]. J Clin Endocrinol Metab199984(9):3082-3092.
[34]
Isidori AM, Venneri MA, Graziadio C, et al. Effect of once-daily, modified-release hydrocortisone versus standard glucocorticoid therapy on metabolism and innate immunity in patients with adrenal insufficiency (DREAM): a single-blind, randomised controlled trial[J]. Lancet Diabetes Endocrinol20186(3):173-185.
[35]
Johannsson G, Nilsson AG, Bergthorsdottir R, et al. Improved cortisol exposure-time profile and outcome in patients with adrenal insufficiency: a prospective randomized trial of a novel hydrocortisone dual-release formulation[J]. J Clin Endocrinol Metab201297(2):473-481.
[36]
Guarnotta V, Ciresi A, Pillitteri G, et al. Improved insulin sensitivity and secretion in prediabetic patients with adrenal insufficiency on dual-release hydrocortisone treatment: a 36-month retrospective analysis[J]. Clin Endocrinol201888(5):665-672.
[37]
Nilsson AG, Bergthorsdottir R, Burman P, et al. Long-term safety of once-daily, dual-release hydrocortisone in patients with adrenal insufficiency: a phase 3b, open-label, extension study[J]. Eur J Endocrinol2017176(6):715-725.
[38]
Frey KR, Kienitz T, Schulz J, et al. Prednisolone is associated with a worse bone mineral density in primary adrenal insufficiency[J]. Endocr Connect20187(6):811-818.
[39]
Quinkler M, Ekman B, Marelli C, et al. Prednisolone is associated with a worse lipid profile than hydrocortisone in patients with adrenal insufficiency[J]. Endocr Eonnect20176(1):1-8.
[40]
Quinkler M, Hahner S, Johannsson G, et al. Saving lives of patients with adrenal insufficiency: a pan-European initiative?[J]. Clin Endocrinol201480(3):319-321.
[41]
Hahner S, Loeffler M, Bleicken B, et al. Epidemiology of adrenal crisis in chronic adrenal insufficiency: the need for new prevention strategies[J]. Eur J Endocrinol2010162(3):597-602.
[42]
Lekarev O, New MI. Adrenal disease in pregnancy[J]. Best Pract Res Clin Endocrinol Metab201125(6):959-973.
[43]
Ahmed M, Bashir M, Okunoye GO, et al. Adrenal disease and pregnancy: an overview[J]. Obstet Gynaecol202123(4):265-277.
[44]
Bothou C, Anand G, Li D, et al. Current management and outcome of pregnancies in women with adrenal insufficiency: experience from a multicenter survey[J]. J Clin Endocrinol Metab2020105(8):e2853-2863.
[45]
Cheang KI, Sharma ST, Nestler JE. Is metformin a primary ovulatory agent in patients with polycystic ovary syndrome?[J]. Gynecol Endocrinol200622(11):595-604.
[46]
Greenberger PA, Odeh YK, Frederiksen MC, et al. Pharmacokinetics of prednisolone transfer to breast milk[J]. Clin Pharmacol Ther199353(3):324-328.
[47]
Arlt W, Society for Endocrinology Clinical Committee. Society For Endocrinology Endocrine emergency guidance: emergency management of acute adrenal insufficiency (adrenal crisis) in adult patients[J]. Endocr Connect20165(5):G1-3.
[1] 朱成美, 赵巧梅, 邓学东. 经阴道超声联合生理盐水灌注直肠子宫陷凹对腹膜型子宫内膜异位症的诊断价值[J]. 中华医学超声杂志(电子版), 2024, 21(01): 32-36.
[2] 谭芳, 杨娇娇, 范思涵, 叶彩玲, 纪学芹. 产前超声心动图在先天性血管环诊断中的价值[J]. 中华医学超声杂志(电子版), 2024, 21(01): 37-41.
[3] 王佳佳, 王丽丽, 彭梅, 姜凡. 基于2020至2021年安徽省哨所医院质量控制数据探讨超声诊断符合率影响指标[J]. 中华医学超声杂志(电子版), 2024, 21(01): 63-68.
[4] 陈穹, 潘鑫, 应伟峰, 侯羽宇, 路明, 安冬清, 顾佳瑶, 彭卫军. 数字乳腺体层合成和全视野数字乳腺X线摄影技术在不同体位组合下的诊断效能[J]. 中华乳腺病杂志(电子版), 2024, 18(01): 25-30.
[5] 杨友涵, 文印宪, 陈廖斌. 噬菌体用于关节假体周围感染治疗的研究进展[J]. 中华关节外科杂志(电子版), 2024, 18(01): 125-130.
[6] 中华医学会肿瘤学分会早诊早治学组. 中国结直肠癌早诊早治专家共识(2023版)[J]. 中华普通外科学文献(电子版), 2024, 18(01): 1-13.
[7] 彭旭, 邵永孚, 李铎, 邹瑞, 邢贞明. 结肠肝曲癌的诊断和外科治疗[J]. 中华普外科手术学杂志(电子版), 2024, 18(01): 108-110.
[8] 白睿, 孙备. 自身免疫性胰腺炎和胰腺导管腺癌鉴别的策略与思考[J]. 中华肝脏外科手术学电子杂志, 2024, 13(02): 121-126.
[9] 郁凯, 闵先军. 胸锁关节脱位的诊治现状[J]. 中华肩肘外科电子杂志, 2024, 12(01): 10-13.
[10] 崔德栋, 周敏, 周传海, 龙毅, 侯景义, 杨睿. 肩关节特殊体查试验对肩胛下肌腱撕裂诊断的价值[J]. 中华肩肘外科电子杂志, 2024, 12(01): 14-20.
[11] 陈娟, 胡晓华, 李洪梅, 王志军. CT小肠造影对克罗恩病的诊断评估价值[J]. 中华消化病与影像杂志(电子版), 2024, 14(01): 41-44.
[12] 黄霓, 张仕勇, 兰茜琳, 周奕, 明兵. 双源CT与MRI在结直肠癌术前分期中的临床价值分析[J]. 中华消化病与影像杂志(电子版), 2024, 14(01): 57-61.
[13] 赵平月, 樊尚荣. 妊娠合并皮质醇增多症的诊治[J]. 中华产科急救电子杂志, 2024, 13(01): 1-5.
[14] 王林源, 熊鑫, 杨坤, 邓勇志. 基于冠状动脉CT血管成像的影像组学列线图鉴别诊断易损斑块的价值[J]. 中华诊断学电子杂志, 2024, 12(01): 1-8.
[15] 初桂芝, 王淑娟, 栾文杰, 郭桂敏, 官春霞, 武晓峰, 李松洋, 王好玲, 栾泽东. 早孕期羊膜带综合征产前超声诊断分析[J]. 中华诊断学电子杂志, 2024, 12(01): 57-60.
阅读次数
全文


摘要