Fitzgerald D, Willis D, Usher R, Outerbridge E, Davis G M
Montreal Children's Hospital, Quebec, Canada.
Biol Neonate. 1998;73(1):34-9. doi: 10.1159/000013957.
The efficacy of a 3-day course of dexamethasone (0.5 mg/kg/ day) in 10 preterm infants (< or = 30 weeks gestation) with pulmonary interstitial emphysema (PIE) was studied in a retrospective case review. PIE was diagnosed at a median age of 7.5 days and treatment with dexamethasone began at 8.5 days. Seven of the 10 subjects had at least 2 days of conservative treatment (lowered mean airway pressure) preceding dexamethasone during which the mean airway pressure (MAP), oxygenation index (OI) and mechanical ventilation index (MVI) were not significantly different although within 3 days of dexamethasone each variable improved significantly (p < 0.05). Similarly, for all 10 infants, OI and MAP were significantly lower at 3 and 7 days from baseline (p < 0.005). By day 7, FiO2 (p = 0.022) and MVI (p = 0.011) were significantly lower and PIE had resolved on chest X-ray in 7/9 (78%) and improved in the remaining 2/9 (22%). Nine of the 10 infants survived to term. Three days of dexamethasone was associated with significant clinical improvement in most of these infants. The mechanism may relate to reduced airway oedema and inflammation and reduced airway obstruction.
在一项回顾性病例分析中，研究了为期3天的地塞米松疗程（0.5毫克/千克/天）对10例患有肺间质气肿（PIE）的早产儿（胎龄≤30周）的疗效。PIE的诊断中位年龄为7.5天，地塞米松治疗于8.5天开始。10名受试者中有7名在使用地塞米松之前至少接受了2天的保守治疗（降低平均气道压力），在此期间平均气道压力（MAP）、氧合指数（OI）和机械通气指数（MVI）虽无显著差异，但在使用地塞米松的3天内，每个变量均有显著改善（p<0.05）。同样，对于所有10例婴儿，与基线相比，在第3天和第7天时OI和MAP显著降低（p<0.005）。到第7天，FiO2（p = 0.022）和MVI（p = 0.011）显著降低，9例中的7例（78%）胸部X线片显示PIE已消退，其余2例（22%）有所改善。10例婴儿中有9例存活至足月。对大多数这些婴儿而言，3天地塞米松疗程与显著的临床改善相关。其机制可能与气道水肿和炎症减轻以及气道阻塞减少有关。
