Bourchier D, Weston P J
Waikato Hospital, Hamilton, New Zealand.
Arch Dis Child Fetal Neonatal Ed. 1997 May;76(3):F174-8. doi: 10.1136/fn.76.3.f174.
To compare the efficacy of hydrocortisone with dopamine for the treatment of hypotensive, very low birthweight (VLBW) infants.
Forty infants were randomly allocated to receive either hydrocortisone (n = 21) or dopamine (n = 19).
All 19 infants randomised to dopamine responded; 17 of 21 (81%) did so in the hydrocortisone group. Three of the four non-responders in the hydrocortisone group had clinically significant left to right ductal shunting. The incidence of bronchopulmonary dysplasia, retinopathy of prematurity, intraventricular haemorrhage, necrotising enterocolitis, symptomatic patent ductus arteriosus, hyperglycaemia, sepsis (bacterial or fungal) or survival did not differ between groups. The adrenocorticotrophic hormone (ACTH) stimulated plasma cortisol activity, either before or after treatment, did not differ between the two groups of infants. Although a significant difference in efficacy between dopamine and hydrocortisone was not noted (P = 0.108), there were four treatment failures in the hydrocortisone group, compared with none in the dopamine group.
Both hydrocortisone and dopamine are effective treatments for hypotension in very low birthweight infants.
比较氢化可的松与多巴胺治疗低血压极低出生体重（VLBW）婴儿的疗效。
40例婴儿被随机分为两组，分别接受氢化可的松治疗（n = 21）或多巴胺治疗（n = 19）。
随机接受多巴胺治疗的19例婴儿均有反应；氢化可的松组21例中有17例（81%）有反应。氢化可的松组4例无反应者中有3例存在临床上有意义的左向右导管分流。两组间支气管肺发育不良、早产儿视网膜病变、脑室内出血、坏死性小肠结肠炎、有症状的动脉导管未闭、高血糖、败血症（细菌或真菌性）或生存率的发生率无差异。两组婴儿治疗前或治疗后促肾上腺皮质激素（ACTH）刺激的血浆皮质醇活性无差异。虽然未观察到多巴胺和氢化可的松在疗效上有显著差异（P = 0.108），但氢化可的松组有4例治疗失败，而多巴胺组无治疗失败病例。
氢化可的松和多巴胺都是治疗极低出生体重婴儿低血压的有效方法。
