A randomized, placebo-controlled trial of effects of dexamethasone on hypothalamic-pituitary-adrenal axis in preterm infants.
A randomized, placebo-controlled trial of effects of dexamethasone on hypothalamic-pituitary-adrenal axis in preterm infants.
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一项关于地塞米松对早产儿下丘脑-垂体-肾上腺轴影响的随机、安慰剂对照试验。
DOI：
10.1016/s0022-3476(88)80398-6
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发表时间：
1988
期刊：
影响因子：
--
通讯作者：
Ariagno,RL
中科院分区：
文献类型：
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作者：
Wilson,DM;Baldwin,RB;Ariagno,RL
作为地塞米松治疗27例患有支气管肺发育不良的早产儿的盲法、随机、安慰剂对照研究的一部分，我们调查了7天大剂量糖皮质激素治疗对下丘脑-垂体-肾上腺轴的影响。所有患儿治疗前基础皮质醇浓度中位数为8.2nmog/dl(226nmoL/L)。经促肾上腺皮质激素刺激后，所有婴儿的血清皮质醇浓度均升高，中位数为23.5nmog/dl(649nmoL/L)，中位数升高13.4nμg/dl(37nmoL/L)。糖皮质激素治疗7天后，地塞米松组基础皮质醇浓度和峰值皮质醇浓度显著降低。然而，在ACTH后1-24天，两组患者的血清皮质醇升高程度相同。治疗结束10天后，地塞米松组的基础和峰值皮质醇浓度恢复到与安慰剂组相当的水平。当婴儿服用地塞米松时，体重增加明显减少。然而，在治疗结束后10天，体重增加相当于。这些数据表明，7天的地塞米松治疗对皮质醇分泌有显著但短期的影响，可能还会增加体重。
As part of a blinded, randomized, placebo-controlled study of dexamethasone therapy in 27 preterm infants with bronchopulmonary dysplasia, we investigated the effect of 7 days of high-dose glucocorticoid therapy on the hypothalamic-pituitary-adrenal axis. Before therapy the median basal cortisol concentration in all infants was 8.2 μg/dl (226 nmol/L). After stimulation with 1–24 ACTH, the serum cortisol concentration rose in all infants to a median concentration of 23.5 μg/dl (649 nmol/L), resulting in a median rise of 13.4 μg/dl (37 nmol/L). Immediately after 7 days of glucocorticoid therapy basal and peak cortisol concentrations were significantly decreased in the dexamethasone group. The rise in serum cortisol following 1–24 ACTH, however, remained equivalent in both groups. Ten days after the end of therapy basal and peak cortisol concentrations in the dexamethasone group had returned to levels equivalent to those seen in the placebo group. Weight gain was markedly diminished while the infants were receiving dexamethasone. Weight gains were, however, equivalent 10 days after the end of treatment. These data indicate that 7 days of dexamethasone therapy has significant but short-term effects on cortisol secretion and possibly on weight gain.