Tapia J L, Ramírez R, Cifuentes J, Fabres J, Hübner M E, Bancalari A, Mercado M E, Standen J, Escobar M
Departamento de Pediatría, Hospital Clínico Universidad Católica, Santiago, Chile.
J Pediatr. 1998 Jan;132(1):48-52. doi: 10.1016/s0022-3476(98)70483-4.
This study was carried to evaluate the effect of early administration of dexamethasone on the incidence of bronchopulmonary dysplasia (BPD) and/or death in surfactant-treated preterm infants with respiratory distress syndrome (RDS).
In a multicenter, double-blind, placebo-controlled trial, 109 preterm infants with RDS and birth weights between 700 and 1600 gm, who were treated with mechanical ventilation and surfactant, were randomly assigned before 36 hours of life to receive dexamethasone (n = 55) or placebo (n = 54) for 12 days.
There were no differences in the incidence of BPD and/or death between groups. However, fewer patients in the dexamethasone group were oxygen-dependent at 36 weeks after conception (8% vs 33%, p < 0.05). The dexamethasone group had a lower incidence of necrotizing enterocolitis (0% vs 9%, p < 0.05). The incidence of arterial hypertension, hyperglycemia, and sepsis was not affected by the treatment. Basal and poststimulation serum cortisol levels did not differ between groups.
The administration of dexamethasone early in the course of RDS does not decrease the incidence of BPD and/or death in preterm infants. However, dexamethasone may reduce oxygen dependency at 36 weeks after conception.
本研究旨在评估早期给予地塞米松对接受表面活性剂治疗的呼吸窘迫综合征（RDS）早产儿支气管肺发育不良（BPD）发生率和/或死亡率的影响。
在一项多中心、双盲、安慰剂对照试验中，109例出生体重在700至1600克之间、接受机械通气和表面活性剂治疗的RDS早产儿，在出生36小时前被随机分配接受地塞米松治疗（n = 55）或安慰剂治疗（n = 54），为期12天。
两组之间BPD发生率和/或死亡率无差异。然而，地塞米松组在孕36周时依赖氧气的患者较少（8%对33%，p < 0.05）。地塞米松组坏死性小肠结肠炎的发生率较低（0%对9%，p < 0.05）。动脉高血压、高血糖和败血症的发生率不受治疗影响。两组之间基础和刺激后血清皮质醇水平无差异。
在RDS病程早期给予地塞米松不会降低早产儿BPD发生率和/或死亡率。然而，地塞米松可能会降低孕36周时的氧气依赖。
