危重早产儿血浆皮质醇、促肾上腺皮质激素水平的变化  

Changes of plasma cortisol and adrenocorticotropic hormone levels in critically ill premature infants

作　　者：李霄[1] 刘红霞[1] 张帆[1] 晏长红[1] LI Xiao;LIU Hongxia;ZHANG Fan;YAN Changhong(Premature Infants Ward,Jiangxi Provincial Children's Hospital,Nanchang,Jiangxi 330006,China)

机构地区：[1]江西省儿童医院早产儿病房,江西南昌330006

出　　处：《检验医学与临床》2022年第9期1181-1184,共4页Laboratory Medicine and Clinic

基　　金：江西省卫生健康委员会科技计划项目(20203663)。

摘　　要：目的研究危重早产儿血浆皮质醇、促肾上腺皮质激素(ACTH)水平变化情况。方法选取该院2019年12月至2021年6月收治的早产儿90例为研究对象,根据早产儿胎龄将其分为<32周组、32~<35周组、35~37周组,分别为31例、18例、41例。同时,根据新生儿危重病例评分(NCIS)标准,对早产儿进行危重(NCIS<90分)及非危重(NCIS≥90分)划分。纳入研究的早产儿分别在入院时(日龄≤3 d)、日龄7 d、日龄14 d的8:00-10:00检测血浆皮质醇和ACTH水平。比较各组危重和非危重早产儿不同日龄时血浆皮质醇及ACTH水平。结果不同日龄时,<32周、32~<35周、35~37周组危重早产儿血浆皮质醇水平均高于非危重早产儿,差异有统计学意义(P<0.05)。随着日龄的增长,32~<35周、35~37周组中危重和非危重早产儿的血浆皮质醇水平有降低趋势。不同日龄时,<32周、32~<35周、35~37周组危重早产儿血浆ACTH水平与非危重早产儿比较,差异无统计学意义(P>0.05)。结论危重早产儿血浆皮质醇水平明显升高,且胎龄越大,早产儿机体调节皮质醇分泌的能力越强;但血浆ACTH水平与早产儿病情严重程度无明显关系。Objective To study the changes of plasma cortisol and adrenocorticotropic hormone(ACTH)levels in critically ill premature infants.Methods A total of 90 premature infants admitted to the hospital from December 2019 to June 2021 were selected as the research objects,and they were divided into<32 weeks group,32-<35 weeks group,and 35-37 weeks group according to their gestational age,with 31 cases,18 cases and 41 cases respectively.At the same time,according to the neonatal critical illness score(NCIS)standard,premature infants were classified into critically ill infants(NCIS<90 points)and non-critically ill infants(NCIS≥90 points).In the premature infants included in the study,plasma cortisol and ACTH levels were detected at admission(age≤3 d),7 d and 14 d of age from 8:00 to 10:00.The levels of plasma cortisol and ACTH were compared between critically ill and non-critically ill premature infants in each group of different age.Results At different ages,the plasma cortisol levels of critically ill premature infants were higher than those of non-critically ill premature infants in<32 weeks,32-<35 weeks and 35-37 weeks groups,and the differences were statistically significant(P<0.05).The plasma cortisol levels of critically ill and non-critically ill premature infants in the 32-<35 weeks and 35-37 weeks groups tended to decrease with increasing age.There was no significant difference in plasma ACTH levels between critically ill premature infants and non-critically ill premature infants in<32 weeks,32-<35 weeks and 35-37 weeks groups(P>0.05).Conclusion The plasma cortisol level of critically ill premature infants is significantly increased,and the older the gestational age,the stronger the ability of the body to regulate cortisol secretion,however,the change of plasma ACTH level has no significant relationship with the severity of the premature infants'disease.

关 键 词：早产儿 皮质醇 促肾上腺皮质激素 危重 

分 类 号：R446[医药卫生—诊断学]