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氟康唑治疗库欣综合征的临床运用初探()
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《国际内分泌代谢杂志》[ISSN:1673-4157/CN:12-1383/R]

卷:
41
期数:
2021年02期
页码:
91-95
栏目:
肾上腺疾病专题
出版日期:
2021-03-20

文章信息/Info

Title:
Primary reports about clinical application of fluconazole in Cushing's syndrome
作者:
高玉婷; 杜琴; 刘丽翼; 李延兵; 廖志红
中山大学附属第一医院内分泌科,广州 510000
Author(s):
Gao Yuting;  Du Qin;  Liu Liyi;  Li Yanbing;  Liao Zhihong.
Department of Endocrinology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China
关键词:
氟康唑;  库欣综合征;  皮质醇增多症;  酮康唑
Keywords:
Fluconazole;  Cushing's syndrome;  Hypercortisolism;  Ketoconazole
DOI:
10.3760/cma.j.cn121383-20200624-06054
摘要:
目前我国用于治疗库欣综合征(Cushing's syndrome, CS)的药物很少,无日常可用的抑制肾上腺类固醇生成的药物,酮康唑由于肝毒性退市无法获得,氟康唑是否为临床上可行的皮质醇生成抑制剂?本文对氟康唑用于各类内源性CS的个案疗效、作用机制的基础实验和不良反应报告等研究进行综述,并重点与酮康唑进行比较,为氟康唑应用于CS的临床治疗提供指导。虽然氟康唑降低皮质醇效果不如酮康唑,但它通过抑制11β-羟化酶和17α-羟化酶,对类固醇生成有抑制作用,可用于CS患者的短期治疗,它不良反应小、经济和普及性高。
Abstract:
At present, there are few available drugs for the treatment of Cushing's syndrome(CS)in China. There is no medication for inhibiting steroidogenesis in daily practice here. Ketoconazole is unavailable because it was delisted from the market for its hepatotoxicity. Should fluconazole be a feasible alternative steroidogenesis inhibitor in the clinic? This article reviews the studies about fluconazole for the treatment of all kinds of endogenous CS including the basic experiments on mechanism of action, the research of idiographic cases, reports of side effects, etc. It focuses on comparing fluconazole with ketoconazole, in order to provide evidence for the clinical administration of fluconazole for CS. Fluconazole inhibits 11β-hydroxylase and 17α-hydroxylase, and then reduces the production of adrenal steroids. Although it works less powerful than ketoconazole on reducing cortisol, it could be a short-term treatment option for CS. It has less side effect, low cost and easy accessibility.

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备注/Memo

备注/Memo:
通信作者:廖志红,Email:liaozhh@mail.sysu.edu.cn 基金项目:广州市科技计划项目(201604020090)
更新日期/Last Update: 2021-03-20