RDS早产儿临床分度与早期血清基础皮质醇和促皮质素水平的相关研究

摘要

Objective To investigate relationship the variance of basic cortisol and ACTH in the serum at the early stage of RDS premature infant and the clinical stages of RDS.Methods 47 premature infants with RDS were chosen from the NICU of the Chenzhou People’s First Hospital Affiliated to The University of south China from July 2011 to April 2012 to be the observed group, the venous blood samples of all the 47 premature infants were collected twice with a same time point of 8:00-9:00 AM in thefirst day and the seventh day after admission respectively. The variance of cortisol and ACTH in blood samples were detected and calculated through chemiluminiscence assay. The clinical stages classified into the mild (I-II grades) and moderately severe (III-IV grades) according to the initial chest radiography results.Results The variation of serum basic cortisol and ACTH levels at those two check-point between the mild and moderate serve groups is insignificant.Conclusion The results of this study showed that the serum basic cortisol and ACTH levels of premature infant with gestational age in 30-34 weeks suffered RDS can not be used as the predictor to the clinical stages of RDS.%目的：探讨呼吸窘迫综合征（respiratory distress syndrom，RDS）早产儿早期血清基础皮质醇和促皮质素（ACTH）水平变化及RDS临床分度的关系。方法选取2011年7月～2012年4月南华大学附属郴州市第一人民医院新生儿重症监护室(NICU)收治的47例RDS早产儿作为观察组（RDS早产儿组），根据初次胸片结果（生后6 h内）对观察组进行临床分度，分为轻度RDS（I～I 级）和中重度RDS（I I～IV级），分别于生后24 h内及生后第7 d清晨8∶00～9∶00采集其静脉血，采用化学发光法测定血清基础皮质醇和ACTH值，对轻度、中重度RDS患儿血清基础皮质醇和ACTH水平对比分析。结果轻度RDS组与中重度RDS组比较，生后24h内的血清基础皮质醇水平以及ACTH水平比较，差异无统计学意义；生后第7d血清基础皮质醇水平以及ACTH水平比较，差异无统计学意义。结论胎龄在30～34周的RDS早产儿早期血清基础皮质醇和ACTH水平不能作为RDS临床分度的预测指标。