透過您的圖書館登入
IP:18.119.159.150

摘要


內源性皮質醇分泌過多原因來自腦下垂體腫瘤或是異位性腫瘤分泌促皮質素(adrenocorticotropic hormone, ACTH) 造成腎上腺分泌過多皮質醇,或是腎上腺存在良性腺瘤或惡性腫瘤分泌過量皮質醇。治療庫欣氏症候群的首選是手術切除腫瘤,其次為放射治療。針對手術前或手術後復發產生之高皮質醇症,或是無法經由手術切除腫瘤的病人,或放射治療療效尚未顯著,則需藥物輔助治療。藥理作用分類有:類固醇生成抑制劑(steroidogenesis inhibitor)、糖皮質素受器拮抗劑及直接作用於腦下垂體腫瘤的藥物。合併數種藥物之加成作用控制高皮質醇症,可減少使用劑量及降低藥物不良反應之風險。

參考文獻


Nieman LK, Biller BM, Findling JW, et al. Endocrine Society. Treatment of Cushing’s syndrome: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab 2015;100:2807-31.
Nicholas A. Tritos, Adrenally Directed Medical Therapies for Cushing Syndrome. J Clin Endocrinol Metab 2021;106:16-25.
Pont A, Williams PL, Loose DS, et al. Ketoconazole blocks adrenal steroid synthesis. Ann Intern Med 1982;97:370-2.
Castinetti F, Guignat L, Giraud P, et al. Ketoconazole in Cushing’s disease: is it worth a try? J Clin Endocrinol Metab 2014;99:1623-30.
Blum RA, D’Andrea DT, Florentino BM, et al. Increased gastric pH and the bioavailability of fluconazole and ketoconazole. Ann Intern Med 1991;114:755-7.

延伸閱讀


國際替代計量