新生儿缺氧缺血性脑病应用糖皮质激素对肾上腺皮质功能的影响.pdfVIP

· 366· 中国妇幼保健2008年第23卷 新生儿缺氧缺血性脑病应用糖皮质激素对肾上腺皮质功能的影响 周 谦 廖 志① 付师亭 刘 丽 四川省成都市第二人民医院儿科 610017 中国图书分类号 R722 文献标识码 A 文章编号 1001-4411(2008)03-366-02 【摘 要】 目的：探讨新生儿缺氧缺血性脑病 (HIE)应用糖皮质激素治疗时对肾上腺皮质功能的影响。方法：在3项支 持、3项对症治疗原则的基础上，将59例HIE患儿按单双号法随机分为A组29例 (地塞米松2 mg一·kg一·d 治疗组)和B 组30例 (地塞米松0．5—1 mg一·kg～·d 治疗组)；另外随机选30例正常儿作为对照组。分别于24 h和4日内测定血浆皮质 醇 (COR)和促肾上腺皮质激素 (ACTH)。结果：HIE时患儿COR明显升高，与正常对照组比较有显著性差异 (P0．05)。而 ACTH有下降趋势，与正常对照组比较无统计学差异 (P0．05)；A组治疗后COR明显下降 (P0．01)，ACTH则有上升趋势； B组治疗后COR下降不明显，但ACTH明显增加。结论：HIE时短期应用糖皮质激素不会造成肾上腺皮质功能的抑制。 【关键词】 缺氧缺血性脑病 地塞米松 肾上腺皮质 The effects of glucocorticoid on function of adrenal cortex of the neonates with hy． poxic——ischemic encephalopathy ZHOU Qian，LIAO Zhi，F Shi— ，et a1．Department of Pediatrics，Chengdu Second Peoples Hospital，Chengdu 610017．China [Abstract] Objective：To study effects of glucocorticoid on function of a~enal cortex of the neonates with hypoxic—ischemic en— cephalopathy(HIE)．Methods：Based on the three kinds of supporting treatments and the three kinds of heteropathy and under the in— formed consent of the parents，59 cases of HIE were half—randomly divided into A group(dexamethasone 2 mg一·kg一·d )consisted 0f 29 cases and B group(dexamethasone 0．5—1 mg～·kg～·d )consisted of30cases．Blood samples were obtained at the age of 1 day and 4 days after birth from 59 neonates with HIE and anormal control group consisted of 30 cases for measuring serum cortisol(COR)and adrenocorticotropic hormone(ACTH)respectively．Results：The results showed that serum COR was significantly higher in 59 cases with HIE neonates compared to that a normal control consisted of 30 cases(P0．05)，while decreased tendency of ACTH had no statistical sig— nificance compared to that of normal control group(P0．05)．COR of A group was significantly lowered，but ACTH showed the ascending tendency after treatment．COR of B group Was not lowered，but ACTH was significantl