Effect of different doses of glucocorticoid replacement therapy on hormone exposure in patients with pituitary insufficiency
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 Hos-pital 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 com-pared 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 treat-ment,and the health status of patients in the low-dose group was significantly better than that in the normal-dose group and the high-dose group(P＜0.05).There were no significant differences in physical function,physiological function,cognitive function,social function,and role function among the three groups of patients(P＞0.05).Conclusion The impact of personalized replacement therapy with different doses of glucocorticoids on hormone exposure varies in patients with pituitary insufficiency.During treatment,it is necessary to monitor changes in patients'blood lipids and blood sugar.Low-dose glucocorticoid replacement therapy can effectively reduce the risk of glucocorticoids exposure for patients.Clinically,individualized dosing treatment can be performed based on different symptoms of patients to improve their quality of life.
万方数据
维普
