糖皮质激素防治早产儿支气管肺发育不良的争议  

Controversies about glucocorticoid for prevention and treatment of bronchopulmonary dysplasia in premature infants

作　　者：刘思宇 段江[1] Liu Siyu;Duan Jiang(Department of Pediatrics,the First Affiliated Hospital of Kunming Medical University,Kunming 650032,China)

机构地区：[1]昆明医科大学第一附属医院儿科,650032

出　　处：《中国小儿急救医学》2022年第6期423-427,共5页Chinese Pediatric Emergency Medicine

基　　金：云南省科技厅—昆明医科大学应用基础研究联合专项资金面上项目(2019FE001(-050));云南省高层次人才培养支持计划"名医"专项(RLMY20200007)。

摘　　要：支气管肺发育不良是引起早产儿死亡以及遗留远期器官功能障碍的重要原因。目前缺乏针对BPD的根本性治疗手段,临床常使用糖皮质激素以降低BPD的发生风险和严重程度。糖皮质激素防治BPD有全身性给药、吸入给药以及经气管给药等方式。在糖皮质激素提供抗炎症等益处的同时,也带来神经发育损伤等不良反应。针对糖皮质激素的剂型、给药时机和剂量等方面存在多种方案,不同研究的临床利弊结论也不一致,需要更高质量的临床试验为临床应用糖皮质激素防治BPD提供证据支持。Bronchopulmonary dysplasia(BPD)is an important cause of premature infant mortality and long-term organ dysfunction in survivors.There is currently no fundamental treatment for BPD,and glucocorticoids are often used clinically to reduce the risk and severity of BPD.There are systemic administration,inhalation administration and transtracheal administration of glucocorticoids for the prevention and treatment of BPD.Glucocorticoids provide benefits such as anti-inflammatory,but may also cause side effects such as neurodevelopmental impairment.There are various schemes for the dosage form,timing of administration,and cumulative dose of glucocorticoids administration.The clinical advantages and disadvantages of different schemes are inconsistent and controversial.Higher quality clinical trials are needed to provide evidence to support the use of glucocorticoids for the prevention and treatment of BPD.

关 键 词：支气管肺发育不良 糖皮质激素 炎症 早产儿 

分 类 号：R722.6[医药卫生—儿科]