van den Anker J N, Hop W C, de Groot R, van der Heijden B J, Broerse H M, Lindemans J, Sauer P J
Department of Pediatrics, Erasmus University Rotterdam, The Netherlands.
Pediatr Res. 1994 Nov;36(5):578-81. doi: 10.1203/00006450-199411000-00006.
The effects of gestational age (GA), body weight, and prenatal exposure to betamethasone and indomethacin on the glomerular filtration rate (GFR) on d 3 of life in preterm infants were studied. GFR measurements were performed in 147 preterm infants with a GA between 23.4 and 37.0 wk by means of the continuous inulin infusion technique. Mean GFR values increased significantly with GA (r = 0.60, p < 0.001) and with body weight (r = 0.44, p < 0.001). Multivariate analysis indicated that GA was the most important determinant for this increase. Prenatal exposure to indomethacin resulted in significantly lower GFR values (-0.15 +/- 0.03 mL/min, p < 0.001) at d 3 after birth. Prenatal administration of betamethasone and indomethacin significantly (p < 0.001) increased the GFR in comparison with exposure to indomethacin alone to levels not different than those seen in patients who were not prenatally exposed to betamethasone or indomethacin. GFR measurements were repeated in 40 preterm infants on d 10 after birth. During this 7-d period, a significant increase in GFR values (0.17 +/- 0.03 mL/min, p < 0.001) was detected. This postnatal increase in GFR values was independent of GA and was not influenced by prenatal exposure to betamethasone or indomethacin. We conclude that prenatal exposure to betamethasone or indomethacin exerts significant effects on the renal function of preterm infants in the first days of life.
研究了胎龄（GA）、体重以及产前使用倍他米松和吲哚美辛对早产儿出生后第3天肾小球滤过率（GFR）的影响。采用持续菊粉输注技术，对147例GA在23.4至37.0周之间的早产儿进行了GFR测量。平均GFR值随GA（r = 0.60，p < 0.001）和体重（r = 0.44，p < 0.001）显著增加。多变量分析表明，GA是这种增加的最重要决定因素。产前暴露于吲哚美辛导致出生后第3天的GFR值显著降低（-0.15 +/- 0.03 mL/min，p < 0.001）。与单独暴露于吲哚美辛相比，产前给予倍他米松和吲哚美辛显著（p < 0.001）增加了GFR，使其达到与未产前暴露于倍他米松或吲哚美辛的患者所见水平无差异。对40例早产儿在出生后第10天重复进行了GFR测量。在这7天期间，检测到GFR值显著增加（0.17 +/- 0.03 mL/min，p < 0.001）。出生后GFR值的这种增加与GA无关，且不受产前暴露于倍他米松或吲哚美辛的影响。我们得出结论，产前暴露于倍他米松或吲哚美辛在生命的最初几天对早产儿的肾功能有显著影响。
