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首页> 外文期刊>Pediatrics: Official Publication of the American Academy of Pediatrics >Links between early adrenal function and respiratory outcome in preterm infants: airway inflammation and patent ductus arteriosus.
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Links between early adrenal function and respiratory outcome in preterm infants: airway inflammation and patent ductus arteriosus.

机译：早产儿的早期肾上腺功能与呼吸功能之间的联系：气道炎症和动脉导管未闭。

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OBJECTIVE: To investigate the relationship of cortisol concentrations during the first week of life to patent ductus arteriosus (PDA), markers of lung inflammation, and respiratory outcome in very low birth weight infants. METHODS: Newborns <1,500 g birth weight were prospectively enrolled at 2 centers. Serum cortisol was measured 3 times during days 2 to 7 of life. Tracheal lavage was performed on intubated infants and analyzed for interleukin-1beta, -6, and -8, and for total protein, albumin, and alpha-1 protease inhibitor. Infants receiving prenatal glucocorticoids were excluded. RESULTS: We obtained 337 cortisol values from 125 infants. Infants treated for PDA had lower cortisol values after day 2. One hundred thirty-three tracheal fluid samples were obtained on matching days from 71 intubated infants. Cortisol correlated inversely with tracheal interleukins and proteins. Lower cortisol values during the second half of the week correlated with longer duration of supplemental oxygen therapy and with subsequent development of chronic lung disease at 28 days and at 36 weeks. CONCLUSION: Infants with lower cortisol values in the first week of life had an increased incidence of PDA, increased lung inflammation, and an increased incidence of chronic lung disease. These findings suggest that early adrenal insufficiency may underlie the previously observed association of increased lung inflammation and PDA with adverse respiratory outcome in this population.
机译：目的：研究极低出生体重婴儿出生后第一周皮质醇浓度与动脉导管未闭（PDA），肺部炎症标志物和呼吸结果的关系。方法：前瞻性地在两个中心登记了出生体重<1,500 g的新生儿。在生命的2至7天中测量了3次血清皮质醇。对插管婴儿进行气管灌洗，并分析其白介素-1β，-6和-8以及总蛋白，白蛋白和α-1蛋白酶抑制剂。排除接受产前糖皮质激素治疗的婴儿。结果：我们从125名婴儿中获得了337皮质醇值。接受PDA治疗的婴儿在第2天后的皮质醇值较低。在匹配的当天，从71位插管婴儿中获得了133个气管液样本。皮质醇与气管白介素和蛋白质呈负相关。下半周皮质醇值降低与补充氧疗的持续时间较长，以及随后在28天和36周时发生慢性肺部疾病有关。结论：出生后第一周皮质醇值较低的婴儿，PDA的发生率增加，肺部炎症增加，慢性肺部疾病的发生率增加。这些发现表明，早期肾上腺功能不全可能是先前观察到的该人群中肺炎症和PDA升高与不良呼吸道结局的关联的基础。

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