不同疗程产前糖皮质激素干预对双胎早产儿短期结局的影响  

Short-term clinical outcomes of different courses of antenatal corticosteroids for preterm twins

作　　者：孙冬梅 齐志业[1] 钟庆华[1] 刘思宇 范宝文 汤潇潇 何艺 李晚欣 高卓怡 谢云波[1] 杨丽[1] 宁月 梁琨[1] 段江[1] Sun Dongmei;Qi Zhiye;Zhong Qinghua;Liu Siyu;Fan Baowen;Tang Xiaoxiao;He Yi;Li Wanxin;Gao Zhuoyi;Xie Yunbo;Yang Li;Ning Yue;Liang Kun;Duan Jiang(Department of Pediatrics,Children'Medical Center,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童医学中心儿内科,昆明650032

出　　处：《中华新生儿科杂志（中英文）》2023年第9期539-544,共6页Chinese Journal of Neonatology

基　　金：云南省高层次人才培养支持计划“名医”专项(RLMY2020007);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))。

摘　　要：目的探讨使用不同疗程产前糖皮质激素(antenatal corticosteroids,ACS)干预的双胎早产儿短期临床结局。方法采用回顾性队列研究,选取2017年1月至2021年12月昆明医科大学第一附属医院新生儿病房收治、接受ACS干预的双胎早产儿为研究对象。以ACS使用疗程不同分为单一疗程组、不足疗程组和重复疗程组,分析ACS不同疗程干预的双胎早产儿短期结局。应用SPSS 25.0统计软件进行数据分析。结果共纳入286例,其中单一疗程组128例,不足疗程组89例,重复疗程组69例。与单一疗程组相比,不足疗程组(OR=2.332,95%CI 1.028~5.293,P=0.043)和重复疗程组(OR=3.872,95%CI 1.104~13.584,P=0.034)双胎早产儿发生新生儿呼吸窘迫综合征的风险增加,重复疗程组出生身长(β=-0.016,95%CI-0.029~-0.002,P=0.024)降低。结论不足疗程和重复疗程使用ACS的双胎早产儿新生儿呼吸窘迫综合征发生风险增加。在获得进一步有效证据之前,应按照足疗程规范使用ACS。Objective To study the short-term clinical outcomes of different courses of antenatal corticosteroids(ACS)for preterm twins.Methods From January 2017 to December 2021,preterm twins with gestational age(GA)24-34 weeks admitted to the neonatal ward of our hospital and received ACS were retrospectively studied.The infants were assigned into single-course group,partial-course group and multiple-course group according to ACS courses.The short-term clinical outcomes were compared among the groups.SPSS software version 25.0 was used for statistical analysis.Results A total of 286 infants were enrolled in this study,including 128 in single-course group,89 in partial-course group and 69 in multiple-course group.Compared with single-course group,the risks of neonatal respiratory distress syndrome(RDS)in both partial-course group(OR=2.332,95%CI 1.028-5.293,P=0.043)and multiple-course group(OR=3.872,95%CI 1.104-13.584,P=0.034)were higher.The birth length in multiple-course group(β=-0.016,95%CI-0.029--0.002,P=0.024)was lower than single-course group.Conclusions The risks of neonatal RDS in preterm twins are higher in partial-course and multiple-course of ACS.A full course of ACS should be used to prevent neonatal RDS until further evidence of effectiveness is available.

关 键 词：产前糖皮质激素 新生儿呼吸窘迫综合征 双胎 早产儿 

分 类 号：R722.6[医药卫生—儿科]