摘要
目的：探讨危重新生儿肾上腺皮质功能状态与病情严重程度的关系及促肾上腺皮质激素（ACTH）刺激试验对肾上腺皮质功能不全患儿预后的作用。方法：根据新生儿危重病例评分法（NCIS）,将2011年10月~2012年11月石河子大学医学院第一附属医院收治的34周≤胎龄﹤42周、日龄0.05）;轻度危重组和重度危重组AI的发生率分别为28.57%和47.37%,二者比较差异有统计学意义（P0.05）;合并AI的患儿中,小剂量ACTH刺激试验后的皮质醇水平、收缩压和血糖水平较刺激试验前升高,血钾和血钠水平比较差异无统计学意义（P〉0.05）。结论：危重新生儿肾上腺皮质功能状态与病情严重程度有关,皮质醇水平在轻度危重症时升高,当病情进一步加重时却未相应升高;危重新生儿合并AI时血压及血糖水平偏低;ACTH刺激能有效升高皮质醇、收缩压及血糖水平,具有一定的治疗作用。
Objective： To explore the relationship between adrenoeortical function of critically ill neonates and the severity of their illness and the effect of adrenocorticotrophic hormone （ACTH） stimulation test on prognosis of neonates with adrenoeortical insufficiency. Methods： Sixty neonates under two days （34 weeks ≤fetal age 〈 42 weeks） treated in the hospital from October 2011 to November 2012 were divided into non - critically ill group, moderate - critically ill group and severe - critically ill group according to neonatal critical illness score （NCIS） . Chemiluminescence immunoassay was used to detect the levels of eortisol; then the neonates were divided into adrenocortieal insufficiency （AI） group and normal adrenocortical function （AN） group according to the levels of cortisol; low -dose ACTH stimulation test was performed among the critically ill neonates with AI ; the changes of cortisol levels, blood pressures, blood glucose levels, blood potassium levels and blood sodium levels in different groups were observed. Results： The levels of cortisol in non - critically ill group, moderate - critically ill group and severe - critically ill group were （ 12. 82 ± 3.96 ） μg/dL, （ 20. 72 ± 10. 65 ） μg/dL and （21.67 ± 8.58 ） μg/dL, respectively ; the levels of cortisol in moderate - critically ill group and severe - critically ill group were statistically significantly higher than that in non - critically ill group （ P 〈 0. 05 ） ; there was no statistically significant difference between moderate - critically ill group and severe - critically ill group （ P 〉 0. 05 ） . The incidence rates of AI in moderate - critically ill group and severe - critically ill group were 28.57% and 47.37% , respectively, there was statistically significant difference between the two groups （P 〈 0.05 ） ; among the critically ill neonates, the level of cortisol, systolic pressure and blood glucose level in AI group were statistically significantly lower than those in AN group
出处
《中国妇幼保健》
CAS
北大核心
2014年第29期4762-4764,共3页
Maternal and Child Health Care of China
关键词
危重新生儿
皮质醇
危重病例评分
促肾上腺皮质激素
Critically ill neonate
Cortisol
Neonatal critical illness score
Adrenoeorticotrophic hormone
