Srivastava T, Merchant R H, Ambadekar M C
Division of Neonatology, Bai Jerbai Wadia Hospital for Children, Parel, Bombay.
Indian Pediatr. 1994 Aug;31(8):923-8.
Cord blood cortisol levels were analyzed in 121 neonates, using a "Coat a Count" RIA kit. Forty two appropriate for gestation age (AGA) preterms < 34 weeks who had not received antenatal dexamethasone constituted Group A, 32 AGA preterms < 34 weeks gestation who had received dexamethasone antenatally comprised Group B, while Group C consisted of 47 term normal neonates. Cortisol levels were compared in these 3 groups and correlated to the development of respiratory distress syndrome (RDS). It was observed tht preterms (Groups A and B) had significantly (p < 0.005) lower levels (8.45 +/- 6.31 micrograms/dl) compared to term neonates (11.67 +/- 4.68 micrograms/dl). Antenatal dexamethasone therapy did not significantly alter cortisol levels within the group of preterms. There was a significant difference (p < 0.02) in cortisol levels between those preterms who developed RDS (5.41 +/- 4.91 micrograms/dl) and those who did not (9.58 +/- 6.45 micrograms/dl). Preterms (Grous A and B) who did not develop RDS had cortisol levels comparable to term neonates. There was a significant reduction in the incidence of RDS (p < 0.05) in preterms who had received antenatal dexamethasone. Cord blood cortisol levels < or = 7 micrograms/dl had a positive predictive accuracy of 36.59% and negative predictive accuracy of 93.75% in predicting onset of RDS.
使用“Coat a Count”放射免疫分析试剂盒对121例新生儿的脐血皮质醇水平进行了分析。42例胎龄<34周、未接受产前地塞米松治疗的适于胎龄（AGA）早产儿组成A组，32例胎龄<34周、接受过产前地塞米松治疗的AGA早产儿组成B组，而C组由47例足月儿组成。比较了这3组的皮质醇水平，并将其与呼吸窘迫综合征（RDS）的发生情况相关联。结果发现，与足月儿（11.67±4.68微克/分升）相比，早产儿（A组和B组）的皮质醇水平显著降低（p<0.005）（8.45±6.31微克/分升）。产前地塞米松治疗并未显著改变早产儿组内的皮质醇水平。发生RDS的早产儿（5.41±4.91微克/分升）与未发生RDS的早产儿（9.58±6.45微克/分升）之间的皮质醇水平存在显著差异（p<0.02）。未发生RDS的早产儿（A组和B组）的皮质醇水平与足月儿相当。接受产前地塞米松治疗的早产儿中RDS的发生率显著降低（p<0.05）。脐血皮质醇水平≤7微克/分升在预测RDS发作方面的阳性预测准确率为36.59%，阴性预测准确率为93.75%。
