Brain development of the preterm neonate after neonatal hydrocortisone treatment for chronic lung disease.
Brain development of the preterm neonate after neonatal hydrocortisone treatment for chronic lung disease.
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DOI：
10.1203/pdr.0b013e3181b3aec5
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发表时间：
2009-11
影响因子：
3.6
通讯作者：
de Vries LS
中科院分区：
文献类型：
--
作者：
Benders MJ;Groenendaal F;van Bel F;Ha Vinh R;Dubois J;Lazeyras F;Warfield SK;Hüppi PS;de Vries LS
先前的研究报告了早产儿慢性肺病的新生儿地塞米松治疗后大脑皮质灰质发育受损和神经发育障碍。氢化可的松治疗对神经认知结果没有长期影响。进行了一项前瞻性研究，以评估接受新生儿氢化可的松治疗慢性肺病的早产儿足月时的脑生长。38例早产儿（n=19例氢化可的松，n=19例对照）出生时胎龄匹配。胎龄和出生体重分别为27.0±1.4 vs.27.6 ±1.1周（p=ns）和826±173 vs.1017 ±202 g（p<0.05）。研究的婴儿为足月等效年龄。氢化可的松以5 mg/kg/天的剂量开始给药1周，随后在3周内逐渐减量。使用3D-MRI技术定量脑组织体积：皮质灰质、基底节/丘脑、无髓鞘白色物质、有髓鞘白色物质、小脑和脑脊液。接受氢化可的松治疗的婴儿呼吸窘迫更严重。在足月等效年龄时，两组之间的脑组织体积无差异。总之，氢化可的松治疗慢性肺部疾病后，在相当的足月年龄测量，对脑生长没有影响。
Previous studies reported impaired cerebral cortical gray matter development and neurodevelopmental impairment following neonatal dexamethasone treatment for chronic lung disease in preterm newborns. No long-term effects on neurocognitive outcome have yet been shown for hydrocortisone treatment. A prospective study was performed to evaluate brain growth at term in preterm infants who did receive neonatal hydrocortisone for chronic lung disease. Thirty-eight preterm infants (n=19 hydrocortisone, n=19 controls) were matched for gestational age at birth. Gestational age and birth weight were 27.0±1.4 vs. 27.6±1.1 weeks (p=ns), and 826±173 vs. 1017±202 gram respectively (p<0.05). Infants were studied at term equivalent age. Hydrocortisone was started with a dose of 5 mg/kg/day for 1 week, followed by a tapering course over 3 weeks. A 3D-MRI technique was used to quantify cerebral tissue volumes: cortical grey matter, basal ganglia/thalami, unmyelinated white matter, myelinated white matter, cerebellum, and cerebrospinal fluid. Infants who were treated with hydrocortisone had more severe respiratory distress. There were no differences in cerebral tissue volumes between the 2 groups at term equivalent age. In conclusion, no effect on brain growth, measured at term equivalent age, was shown following treatment with hydrocortisone for chronic lung disease.