新生猪缺氧缺血性脑损伤时地塞米松对肾上腺皮质功能的影响  

The Effects of Deramethasone on the Function of Adrenal Cortex in Piglets with Hgpoxic-ischemic Brain Damage

作　　者：周密[1] 姚裕家[1] 李炜如[1] 郭茜 

机构地区：[1]华西医科大学附属第二医院儿科,成都610041 [2]新疆克拉玛依石油局总医院儿科

出　　处：《中华围产医学杂志》1999年第3期181-183,共3页Chinese Journal of Perinatal Medicine

摘　　要：目的探讨新生猪缺氧缺血性脑损伤（hypoxic－ischemicbraindamage，HIBD）时地塞米松对肾腺皮质功能的影响。方法在建立新生猪HIBD模型的基础上，对治疗组新生猪使用不同剂量地塞米松（5mg·kg－1·d－1和1mg·kg·d-1）共3天，分别于第24小时，第48小时及第72小时采股静脉血收集血清，以放射免疫法（radioimmunoassay，RIA）测定其皮质醇（cortisol，COR）和促肾上腺皮质激素（adrenocortico-trophichormone,ACTH）浓度，并取各组第3天新生猪各2只作肾上腺病理检查。结果HIBD新生猪ACTH、COR浓度明显高于正常对照组（P＜0．05）；5mg·kg－1·d-1治疗组ACTH、COR浓度较HIBD组下降，但仍高于正常对照组。1mg·kg-1·d-1治疗组ACTH、COR浓度与HIBD组相比无显著性差异。结论短期使用地塞米松可减轻新生猪HIBD脑水肿。不致造成肾上腺皮质组织学改变，但在一定程度上抑制了肾上腺皮质功能。临床新生儿缺氧缺血性脑病（hypoxic－ischemicencephalonathy，HIE）时以使用小剂量为宜。To investigate the effects of deramethason on the function of adrenal cortex in piglets with hypoxic-ischemic brain damage(HIBD). Methotls On the basis of establishing the animal model of HIBD with a piglet, dexamethasone was given intramuscularly in doseof 5 mg.kg-1·d-1 and 1 mg .kg-1.d-1 to two treatment groups respectively for 3 days. Sera of every included piglet was collected at the 24th hour, the 48th hour and the 72th hour after the study began.The concentration of COR and ACTH were measured by means of radioimmunoassay (RIA) andpathological examinations of brain and adrenal tissue were done in every group. Results The concentrations of COR and ACTH of HlBD group were significantly higher than those of normal controlgroup (P<0.05). The concentrations of ACTH and COR of the 5 mg·kg-1 .d-1 group were lowerthan those of HIBD group while there was no difference between 1 mg·kg-1.d-1 and BIBD group.Conclusion Large dose of dexamethasone may inhibit the function of adrenal cortex though it couldalleviate the cerebral edema, and could not cause any hemorrhage, necrosis and atrophy 0f adrenalcortex within a short period.

关 键 词：肾上腺皮质 地塞米松 缺氧缺血性脑病 新生儿 

分 类 号：R722.120.5[医药卫生—儿科]