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产后使用皮质类固醇预防和治疗早产新生儿慢性肺部疾病

Postnatal corticosteroids for prevention and treatment of chronic lung disease in the preterm newborn.

作者信息

Gupta Sachin, Prasanth Kaninghat, Chen Chung-Ming, Yeh Tsu F

机构信息

Department of Pediatrics, John Stroger Jr. Hospital of Cook County, Chicago, IL 60612, USA.

出版信息

Int J Pediatr. 2012;2012:315642. doi: 10.1155/2012/315642. Epub 2011 Oct 4.

Abstract

Despite significant progress in the treatment of preterm neonates, bronchopulmonary dysplasia (BPD) continues to be a major cause of neonatal morbidity. Affected infants suffered from long-term pulmonary and nonpulmonary sequel. The pulmonary sequels include reactive airway disease and asthma during childhood and adolescence. Nonpulmonary sequels include poor coordination and muscle tone, difficulty in walking, vision and hearing problems, delayed cognitive development, and poor academic achievement. As inflammation seems to be a primary mediator of injury in pathogenesis of BPD, role of steroids as antiinflammatory agent has been extensively studied and proven to be efficacious in management. However, evidence is insufficient to make a recommendation regarding other glucocorticoid doses and preparations. Numerous studies have been performed to investigate the effects of steroid. The purpose of this paper is to evaluate these studies in order to elucidate the beneficial and harmful effects of steroid on the prevention and treatment of BPD.

摘要

尽管在早产儿治疗方面取得了显著进展,但支气管肺发育不良(BPD)仍然是新生儿发病的主要原因。受影响的婴儿会出现长期的肺部和非肺部后遗症。肺部后遗症包括儿童期和青春期的反应性气道疾病和哮喘。非肺部后遗症包括协调能力差、肌张力异常、行走困难、视力和听力问题、认知发育迟缓以及学业成绩不佳。由于炎症似乎是BPD发病机制中损伤的主要介质,类固醇作为抗炎剂的作用已得到广泛研究,并被证明在治疗中有效。然而,关于其他糖皮质激素剂量和制剂的证据不足以给出推荐。已经进行了大量研究来调查类固醇的作用。本文的目的是评估这些研究,以阐明类固醇对BPD预防和治疗的有益和有害影响。

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