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产后皮质类固醇在支气管肺发育不良治疗或预防中的作用。

Role of Postnatal Corticosteroids in the Treatment or Prevention of Bronchopulmonary Dysplasia.

作者信息

Bulbul Ali, Bacak Tolga, Avsar Hasan

机构信息

Department of Pediatrics, Division of Neonatology, University of Health Sciences Türkiye, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Türkiye.

出版信息

Sisli Etfal Hastan Tip Bul. 2023 Jun 20;57(2):171-181. doi: 10.14744/SEMB.2023.80688. eCollection 2023.

Abstract

As the frequency of viable low birth weight preterm babies increases, bronchopulmonary dysplasia (BPD), one of the most important morbidities in these babies, also increases. Using postnatal steroids to reduce the development of BPD has not been fully enlightened. Besides all prevention strategies for reducing the development of BPD, it is known that steroid therapy used in the 1 week of life could induce negative neuromotor development according to current data. It may be recommended to administer low-dose dexamethasone between 8 and 49 days in infants dependent on mechanical ventilators in the postnatal period. It is seen that the use of hydrocortisone in the early period does not cause negative neuromotor development, but it cannot prevent the development of BPD as much as dexamethasone. All intensive care units must have their steroid protocol for BPD and use steroids in cases when the BPD development scale score is >60-65% and should have a goal of trying to keep the cumulative dose at the lowest level.

摘要

随着存活的低出生体重早产儿数量增加,支气管肺发育不良(BPD),这类婴儿最重要的发病情况之一,也随之增加。使用产后类固醇来减少BPD的发生尚未完全明确。除了所有减少BPD发生的预防策略外,根据目前的数据,已知在出生后1周使用类固醇疗法可能会导致神经运动发育不良。对于出生后依赖机械通气的婴儿,可能建议在出生后8至49天给予低剂量地塞米松。可以看到,早期使用氢化可的松不会导致神经运动发育不良,但它预防BPD发生的效果不如地塞米松。所有重症监护病房都必须有针对BPD的类固醇治疗方案,在BPD发生量表评分>60 - 65%的情况下使用类固醇,并且应以尽量将累积剂量保持在最低水平为目标。

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Life-threatening bronchopulmonary dysplasia: a British Paediatric Surveillance Unit Study.危及生命的支气管肺发育不良:英国儿科监测单位研究。
Arch Dis Child Fetal Neonatal Ed. 2022 Jan;107(1):13-19. doi: 10.1136/archdischild-2021-322001. Epub 2021 Jun 28.

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