| 栗金亮 谷强 王月红 陈永林 章伟.危重症新生儿肾上腺皮质功能状态的研究[J].,2014,14(7):1336-1338 |
| 危重症新生儿肾上腺皮质功能状态的研究 |
| Study on the Adrenal Function in Critically-ill Neonates |
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| DOI： |
| 中文关键词: 危重症新生儿 皮质醇 危重病例评分 促肾上腺皮质激素 肾上腺皮质功能不全 |
| 英文关键词: Critically ill neonates Cortisol NCIS ACTH Adrenal insufficiency |
| 基金项目: |
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| 中文摘要: |
| 目的：研究危重症新生儿肾上腺皮质功能状态、肾上腺皮质功能不全(AI)的发生率及其与患儿预后的关系。方法：选择我科
收治的日龄<2 天的危重症新生儿52 例(其中早产儿23 例，足月儿29 例)，根据新生儿危重病例评分(NCIS)分为轻度危重组和重
度危重组，分别检测其血清基础皮质醇和小剂量促肾上腺皮质激素(ACTH)刺激实验30 分钟后的清皮质醇峰值。血清基础皮质醇
<15 ug/dl 为合并AI。结果：危重症早产儿基础皮质醇浓度及小剂量ACTH 刺激实验前后皮质醇差值均较足月儿组低[(15.08±
4.98) ug/dl vs (19.65± 9.18) ug/dl，P=0.027；(12.06± 3.71) ug/dl vs (19.09± 4.75) ug/dl，P=0.000]。危重症新生儿合并AI 的发生率
为38.5%，其中早产儿组为47.8%，足月儿组为34.5%。AI组新生儿死亡2 例，未发现AI与患儿的死亡率有关。结论：危重症早产
儿肾上腺皮质功能较足月儿差。危重症新生儿合并AI的发生率较高，但与患儿的死亡率无关。 |
| 英文摘要: |
| Objective:To investigate the adrenal function in neonates with critical illness, the incidence of adrenal insufficiency,
and the relationship between adrenal insufficiency and the prognosis of neonates with critical illness.Methods:Fifty-two neonates
enrolled were divided into two groups: the critically ill preterm infants and the critically ill term infants; then the two groups were
separately divided into two groups according to neonatal critical illness score (NCIS): moderate-critically ill group and severe-critically ill
group. The cortisol of the neonates were detected. All the cases enrolled were stimulated with a low-dose ACTH, then the cortisol were
detected 30 minutes later. Adrenal insufficiency was defined as the basal cortisol was less than 15 ug/dl. Results:The basal cortisol
values and the mean post-simulated increased cortisol level of the critically ill preterm group were lower than that of the term group[
(15.08± 4.98) ug/dl vs (19.65± 9.18) ug/dl, P=0.027; (12.06± 3.71) ug/dl vs (19.09± 4.75) ug/dl, P=0.000]. The total incidence of
adrenal insufficiency in the critically neonates were 38.5%, and the incidence of AI in the preterm group was 47.8% and 34.5% in the
term group. Two neonates with AI died. No relationship between AI and mortality of neonates with critical illness was found.Conclusion:The adrenal function of preterm infants was poorer than that of term infants. The incidence of AI in critically ill neonates
was high, which was not correlated with the mortality of neonates with critical illness. |
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