RESPONSE TO ACTH IN THE NEWBORN
RESPONSE TO ACTH IN THE NEWBORN
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DOI：
10.1136/adc.61.1.57
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发表时间：
1986-01-01
影响因子：
5.2
通讯作者：
HUGHES, IA
中科院分区：
文献类型：
--
作者：
THOMAS, S;MURPHY, JF;HUGHES, IA
对52名新生儿的肾上腺皮质功能进行了研究，这些新生儿被分为三组：早产儿健康组、早产儿疾病组和足月儿疾病组。两组早产儿的基础血浆17-羟孕酮浓度均显著升高。基础血浆皮质醇浓度没有显着差异，虽然他们是最高的早产儿病。所有婴儿对促肾上腺皮质激素（ACTH）刺激（肌内注射36 μ g/kg）都有反应，两种类固醇的浓度都增加了2 - 3倍。一个由5名婴儿组成的亚组，他们高度紧张，但基础血浆皮质醇浓度检测不到，也表现出对ACTH的适当反应。结果提供了有用的参考数据，以评估肾上腺皮质激素的母亲在怀孕期间的婴儿。出生后不久，胎儿肾上腺类固醇生成的模式也发生了变化，这可能受到外源性ACTH刺激的影响。大约有10%的新生儿在压力下无法合成皮质醇，暂时性糖皮质激素替代可能是合适的。
Adrenocortical function was studied in 52 newborn infants who had been divided into three groups: preterm well, preterm ill, and term ill. Basal plasma 17-hydroxyprogesterone concentrations were significantly increased in both groups of preterm infants. There was no significant difference in basal plasma cortisol concentrations, although they were highest in preterm ill infants. All infants responded to adrenocorticotrophic hormone (ACTH) stimulation (36 .mu.g/kg intramuscularly) with a two to threefold increase in the concentration of both steroids. A subgroup of five infants, who were highly stressed but had undetectable basal plasma cortisol concentrations, also showed an appropriate response to ACTH. The results provide useful reference data to assess adrenal function in the infant of a mother given glucocorticoids during pregnancy. There is also a change from the pattern of fetal adrenal steroidogenesis soon after birth, which may be affected by exogenous ACTH stimulation. Roughly 10% of stressed newborns failed to synthesize cortisol basally; temporary glucocorticoid replacement for such infants may be appropriate.