呼吸窘迫综合征早产儿血浆皮质醇、促皮质素水平的变化

目的 观察呼吸窘迫综合征(RDS)早产儿在疾病不同时期血浆皮质醇、促皮质素(ACTH)水平的变化.方法 采集本院新生儿重症监护病房的28 ～34周早产儿49例(RDS组20例,对照组29例),均排除遗传代谢性疾病,母孕期及早产儿出生时均未用过糖皮质激素.全部患儿分别在日龄1d、4d、10 d静脉采血2 mL,留取血标本,分离血浆,通过Roche Elecsys全自动电化学发光免疫分析仪分别检测其血浆皮质醇、ACTH水平.对其3个时间点血浆皮质醇、ACTH水平进行比较.结果 1.RDS组3个时间点血浆皮质醇水平均高于对照组(F=17.518、9.909、8.208,Pa＜0.05).2.RDS组内3个时间点血浆皮质醇水平之间比较,差异有统计学意义(F=26.112,P＜0.05),且随时间呈下降趋势.3.RDS组和对照组之间血浆皮质醇整体水平比较,RDS组高于对照组(F=21.375,P＜0.05).4.RDS组和对照组3个时间点血浆ACTH水平比较,差异均无统计学意义(F=1.045、0.571、0.217,Pa＞0.05).5.RDS组内3个时间点血浆ACTH整体水平比较,差异无统计学意义(F=0.166,P＞0.05).6.RDS组和对照组之间血浆ACTH水平比较,差异无统计学意义(F =0.080,P＞0.05).结论 在早产儿RDS中,血浆皮质醇水平增高与RDS的严重程度及病情发展密切相关.RDS早产儿血浆ACTH水平与疾病的严重程度及病情发展无明显相关.

Changes of Cortisol and Adrenocorticotrophic Hormone in Preterm Infants with Respiratory Distress Syndrome

Objective To observe the changes of cortisol and adrenocorticotrophic hormone(ACTH) level in preterm infants with respi-ratory distress syndrome(RDS) in three different periods. Methods Forty-nine premature infants at 28-34 weeks who all came from Nanjing Children′s Hospital Affiliated to Nanjing Medical University were collected in the trial(RDS group of 20 cases,control group of 29 cases).The infants with genetic diseases,or the application of glucocorticoid during perinatal period were excluded.The plasma cortisol and ACTH were measured on 1 d,4 d and 10 d after birth by using electrochemiluminescence methods on Roche Elecsys automatic immune analysator.The plasma values of cortisol and ACTH at every point time were compared with each other. Results 1.By comparing the plasma va-lues of cortisol in every different period in RDS group were significantly higher than that of the control group(F=17.518,9.909,8.208,Pa<0.05);2.Among the RDS group,comparing the plasma values of cortisol in three different periods,the difference was statistically significant(F=26.112,P<0.05),and the plasma values of cortisol was trendily decreased with time passing;3.To compare the plasma values of cortisol,there was statistically significant difference between the RDS group and the control group(F=21.375,P<0.05);4.There was no significant difference between the RDS group and the control group in the plasma values of ACTH in three different periods(F=1.045,0.571,0.217,Pa>0.05);5.Among the RDS group,comparing the plasma values of ACTH at three different periods,the difference was not statistically significant(F=0.166,P>0.05);6.To compare the plasma values of ACTH,the difference was not statistically significant between the RDS group and the control group(F=0.080,P>0.05). Conclusions The plasma cortisol is correlated with the severity and development of RDS.The plasma ACTH has no correlation with the severity and development of RDS.