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在胎鼠中进行倍他米松和地塞米松之间的安慰剂对照、双盲比较,以促进肺成熟。

A placebo-controlled, blinded comparison between betamethasone and dexamethasone to enhance lung maturation in the fetal mouse.

作者信息

Christensen H D, Sienko A E, Rayburn W F, Gonzalez C L, Coleman F H

机构信息

Department of Obstetrics and Gynecology, University of Oklahoma Health Sciences Center, Oklahoma City 73190, USA.

出版信息

J Soc Gynecol Investig. 1997 May-Jun;4(3):130-4. doi: 10.1016/s1071-5576(97)00021-x.

Abstract

OBJECTIVE

To compare the effects of betamethasone and dexamethasone used to enhance lung maturity of the fetal mouse.

METHODS

Adult CD-1 mice were administered a single dose of either a placebo or different strengths of betamethasone (0.01, 0.025, or 0.10 mg) or dexamethasone (0.025 or 0.10 mg) on day 14.0 (74%) of gestation. The eight gravid mice in each treatment cohort were killed on day 16.5 to assess fetal lung maturity (histologic changes and respiratory patterns) in a blinded manner. Another ten gravid mice in each treatment group were allowed to deliver spontaneously to assess perinatal outcomes.

RESULTS

Compared with the effects from placebo exposure, the 0.10-mg doses of both betamethasone and dexamethasone demonstrated enhanced histologic maturational changes and improved neonatal respiratory efforts. Betamethasone was twofold to threefold more potent than dexamethasone. The fetal crown-rump lengths and the fetal body, lung, and heart weights were indistinguishable among the three treatment groups. Compared with the fetal liver weight in the placebo group (55.0 +/- 2.2 mg), the liver was less heavy after exposure to 0.10 mg of betamethasone (45.6 +/- 2.0 mg; P < .005), 0.025 mg of dexamethasone (47.6 +/- 1.7 mg; P < .02), or 0.10 mg of dexamethasone (43.8 +/- 1.5 mg; P < .001). No significant differences were observed between the 0.10-mg treatments of either corticosteroid and placebo for the duration of gestation, litter size, survival rate, birth weights, or weight gains to postnatal day 26.

CONCLUSION

A single subcutaneous dose of 0.10 mg of betamethasone was twofold to threefold more potent than dexamethasone in accelerating fetal lung maturity without impairing fetal survival or weight gain. The unexpected finding of a reduced fetal liver weight with either corticosteroid warrants clinical correlation.

摘要

目的

比较倍他米松和地塞米松对促进胎鼠肺成熟的效果。

方法

成年CD-1小鼠在妊娠第14.0天(74%)给予单剂量安慰剂或不同强度的倍他米松(0.01、0.025或0.10毫克)或地塞米松(0.025或0.10毫克)。每个治疗组的8只妊娠小鼠在第16.5天处死,以盲法评估胎肺成熟度(组织学变化和呼吸模式)。每个治疗组的另外10只妊娠小鼠自然分娩以评估围产期结局。

结果

与安慰剂暴露的效果相比,0.10毫克剂量的倍他米松和地塞米松均显示出组织学成熟变化增强,新生儿呼吸功能改善。倍他米松的效力比地塞米松强两到三倍。三个治疗组之间的胎头臀长度以及胎儿身体、肺和心脏重量没有差异。与安慰剂组的胎儿肝脏重量(55.0±2.2毫克)相比,暴露于0.10毫克倍他米松(45.6±2.0毫克;P<.005)、0.025毫克地塞米松(47.6±1.7毫克;P<.02)或0.10毫克地塞米松(43.8±1.5毫克;P<.001)后肝脏重量减轻。两种皮质类固醇的0.10毫克治疗与安慰剂在妊娠期、产仔数、存活率、出生体重或出生后第26天的体重增加方面均未观察到显著差异。

结论

单剂量皮下注射0.10毫克倍他米松在加速胎肺成熟方面比地塞米松有效两到三倍,且不影响胎儿存活或体重增加。两种皮质类固醇均导致胎儿肝脏重量减轻这一意外发现值得临床关注。

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