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成人危重症时往往存在相对性肾上腺皮质功能不全,与疾病严重程度和死亡率的增加相关联,此时应用糖皮质激素(glucocorticoid,GC)治疗效果较好。引发成人肾上腺功能不全的机制同样可以引起新生儿下丘脑-垂体-肾上腺(hypothalamic-pituitary-adrenal,HPA)轴应答不足,同时新生儿还有因为子宫外生存过程的过渡而具有自身特点。本文就肾上腺皮质的发育,新生儿肾上腺皮质功能不全的发生机制,检测手段,诊断标准及其治疗的最新进展进行综述。
In adolescent critically ill patients, relative adrenal insufficiency is often associated with increased severity and mortality, and glucocorticoid (GC) therapy is more effective. Mechanisms that trigger adult adrenal insufficiency can also cause hypoxic response to the hypothalamic-pituitary-adrenal (HPA) axis in newborns, as well as newborns with their own characteristics due to the transition to extrauterine survival. This article reviews the development of adrenal cortex, the mechanism of neonatal adrenal insufficiency, the detection methods, diagnostic criteria and the latest progress of its treatment.