呼吸衰竭早产儿肾上腺皮质功能的研究  

Adrenal function of preterm infants with respiratory failure

作　　者：沈云琳[1] 黄绮薇[1] 张宇鸣[2] 张育才[2] 田国力[3] 张国琴[2] 李敏[1] 

机构地区：[1]上海交通大学附属儿童医院新生儿科,200040 [2]上海交通大学附属儿童医院新生儿重症监护病房,200040 [3]上海交通大学附属儿童医院检验科,200040

出　　处：《中国新生儿科杂志》2009年第1期8-10,共3页Chinese Journal of Neonatology

摘　　要：目的研究呼吸衰竭早产儿肾上腺皮质功能的变化,肾上腺皮质功能不全的发生率及其与病情和预后的关系。方法研究对象为住院早产儿43例(研究组33例,对照组10例),分别检测清晨血清基础皮质醇浓度及小剂量促肾上腺皮质激素(ACTH)刺激试验后血清皮质醇峰值。结果需机械通气的呼吸衰竭早产儿血清基础皮质醇浓度[(114.6±76.1)μg/L]和小剂量ACTH刺激试验后血清皮质醇峰值[(232.5±74.6)μg/L]比非机械通气早产儿[(182.1±86.8)、(312.1±93.8)μg/L]低;呼吸衰竭早产儿合并肾上腺皮质功能不全的发生率较高(21.21%);肾上腺皮质功能不全早产儿中无死亡及慢性肺疾病(CLD)病例。结论呼吸衰竭早产儿具有较高肾上腺皮质功能不全的发生率;需机械通气的呼吸衰竭早产儿肾上腺皮质的合成分泌功能较差;Objective To observe the adrenal function in preterm infants with respiratory failure,the incidence of adrenal insufficiency,and the relationships between adrenal function and lung diseases.Methods We selected 43 cases of preterm infants（the studied group of 33 cases,the control group of 10 cases） from Shanghai Children＇s Hospital.Serum cortisol values were measured in the morning.Peak serum cortisol values were measured after 30 minutes low-dose adrenocorticotropic hormone stimulation test.Results The mean basal serum cortisol values [（114.6±76.1） μg/L] and peak serum cortisol values [（232.5±74.6） μg/L] of preterm infants who had the ventilator requirements were significantly lower than that of preterm infants who did not [（182.1±86.8） μg/L、（312.1±93.8） μg/L] in the studied group;The incidence of adrenal insufficiency in preterm infants with respiratory failure was 21.21%;No preterm infants with adrenal insufficiency perished and developed chronic lung disease（CLD）.Conclusion Adrenal insufficiency may occur in preterm infants with respiratory failure;The adrenal function of preterm infants who had ventilator requirements were poor;We do not found relationship between the mortality,the incidence of CLD and adrenal insufficiency.

关 键 词：呼吸功能不全 肾上腺皮质功能试验 婴儿 早产 

分 类 号：R722.6[医药卫生—儿科]