类风湿关节炎患者地塞米松戒断综合征2例并文献复习  

Dexamethasone withdrawal syndrome in 2 patients with rheumatoid arthritis and literature review

作　　者：张丽琼 田源 ZHANG Liqiong;TIAN Yuan(Department of Pharmacy,the Second People’s Hospital of Qujing City,Yunnan,Qujing 655000,China)

机构地区：[1]云南省曲靖市第二人民医院药学部,云南曲靖655000

出　　处：《中国医药科学》2022年第10期193-196,共4页China Medicine And Pharmacy

摘　　要：地塞米松戒断综合征是指使用地塞米松数月或更长时间停药后所产生的全身多系统的临床表现。目前国内对该病的报道较少。医务工作者经常忽视糖皮质激素戒断综合征(GCWS),尤其对于选择糖皮质激素维持治疗的类风湿关节炎(RA)患者,突发疾病住院中断激素治疗,临床表现复杂,诊断难度大,患者住院时间延长。通过报道2例长期服用小剂量地塞米松的RA患者并发髋臼骨折和空腔脏器穿孔的诊治经过,结合文献对GCWS的临床表现发生机制、诊断、治疗用药品种选择和围手术期GCWS品种选择进行探讨,以提高医务工作者对GCWS的认识。Dexamethasone withdrawal syndrome refers to the clinical manifestations of multiple systems throughout the body that occur after several months or longer of dexamethasone withdrawal.At present,there are few reports on this disease in China.Glucocorticoid withdrawal syndrome(GCWS)is often overlooked by medical workers,especially in patients with rheumatoid arthritis(RA)who choose glucocorticoid maintenance therapy.If hormone therapy is interrupted during hospitalization due to sudden illness,the clinical manifestations will be complex and the diagnosis will be difficult,which will prolong the hospitalization time of patients.This paper reports the diagnosis and treatment of two patients with RA complicated with acetabular fracture and perforation of hollow organs after long-term administration of low-dose dexamethasone.In order to improve the understanding of GCWS among medical workers,the literature was combined to investigate the mechanism of clinical manifestations,diagnosis,therapeutic drug selection and perioperative GCWS variety selection.

关 键 词：糖皮质激素 戒断综合征 停药反应 类风湿关节炎 地塞米松 

分 类 号：R453[医药卫生—治疗学]