Doerr H G, Sippell W G, Versmold H T, Bidlingmaier F, Knorr D
Department of Pediatrics, University of Munich, FRG.
Pediatr Res. 1988 May;23(5):525-9. doi: 10.1203/00006450-198805000-00018.
Plasma levels of aldosterone, corticosterone, 11-deoxycorticosterone, progesterone, 17-hydroxyprogesterone, 11-deoxycortisol, cortisol, and cortisone were measured simultaneously by a micromethod of multisteroid analysis in eight vaginally delivered premature infants (PI) of 33-36 wk gestation with uneventful peri- and postnatal course. Mean concentrations (ng/ml) in umbilical arterial and in peripheral venous or capillary plasma sampled longitudinally at age 2 h to 7 days were compared with the same kind of data obtained from a group of 12 term infants (TI) who served as controls. Mean aldosterone was two to five times higher in PI than in TI (umbilical artery, 2 h to 7 days; p less than 0.05), whereas 11-deoxycorticosterone was lower in PI from 2 h (p less than 0.01) until 7 days (NS). Corticosterone was significantly higher in PI than TI at 6 and 24 h after birth, whereas cortisol was slightly lower (NS) in PI in umbilical artery and 2 h after birth, but higher (p less than 0.02) at 6 h, showing less variation in PI than in TI. 17-Hydroxyprogesterone levels in PI were two to three times higher (p less than 0.02) during 6 h until 7 days after birth. The data suggest that PI are able to maintain high aldosterone levels in the early neonatal period. Higher levels of the active glucocorticoids (cortisol and corticosterone) seen after delivery point to a more stressful extrauterine adaptation of PI. Furthermore, the data demonstrate that the adrenal cortex is fully functioning in premature infants (33-36 wk gestation) as well as in term infants.
采用多类固醇分析微方法，同时测定了8例孕33 - 36周、围产期和产后过程平稳的阴道分娩早产儿（PI）血浆中醛固酮、皮质酮、11 - 脱氧皮质酮、孕酮、17 - 羟孕酮、11 - 脱氧皮质醇、皮质醇和可的松的水平。将脐动脉以及出生后2小时至7天纵向采集的外周静脉或毛细血管血浆中的平均浓度（ng/ml），与一组作为对照的12例足月儿（TI）获得的同类数据进行比较。PI的平均醛固酮水平比TI高2至5倍（脐动脉，出生后2小时至7天；p < 0.05），而PI的11 - 脱氧皮质酮从出生后2小时（p < 0.01）到7天（无显著性差异）较低。出生后6小时和24小时，PI的皮质酮显著高于TI，而PI脐动脉和出生后2小时的皮质醇略低（无显著性差异），但在6小时时较高（p < 0.02），表明PI的变化比TI小。出生后6小时至7天，PI的17 - 羟孕酮水平高2至3倍（p < 0.02）。数据表明，PI在新生儿早期能够维持较高的醛固酮水平。分娩后观察到的活性糖皮质激素（皮质醇和皮质酮）水平较高，表明PI的宫外适应压力更大。此外，数据表明，早产（孕33 - 36周）和足月婴儿的肾上腺皮质功能均正常。
