Arnold J D, Bonacruz G, Leslie G I, Veldhuis J D, Milmlow D, Silink M
Department of Neonatology, Royal North Shore Hospital, St. Leonards, NSW, Australia.
Pediatr Res. 1998 Dec;44(6):876-81. doi: 10.1203/00006450-199812000-00009.
We hypothesized that antenatal exposure to glucocorticoids influences subsequent pulsatile cortisol (F) secretion in premature neonates. To test this hypothesis, blood was sampled for plasma F determination via indwelling arterial lines at 15-min intervals for 6 h in 26 clinically stable neonates whose gestational ages were 25-33 wk. Deconvolution analysis was used to characterize F secretion and elimination. Pulsatile F secretion was observed in all neonates. Deconvolution estimates in eight neonates exposed to antenatal glucocorticoids (ANG group) were compared with those of 18 neonates not or only remotely exposed to ANG (No/RG group). The median amplitude of the F secretory burst of the ANG group was significantly less than that of the No/RG group [4.3 nmol/Lv x min and 9.2 nmol/Lv x min, respectively; p = 0.026 (Lv is liter of F distribution volume)]. The number and duration of F secretory bursts was similar for both groups: 5 bursts per 6 h, and 23 versus 16 min. By univariate linear regression analysis, mean arterial blood pressure correlated positively with F secretory burst frequency and F production rate (p = 0.0035, r = 0.55 and p = 0.0067, r = 0.52, respectively). We propose that ANG treatment modulates the amplitude of pulsatile F secretion in premature neonates.
我们假设产前暴露于糖皮质激素会影响早产儿随后的脉冲式皮质醇（F）分泌。为了验证这一假设，对26名孕周为25 - 33周且临床状况稳定的新生儿，通过留置动脉导管每隔15分钟采集一次血样，共采集6小时，用于测定血浆F。采用反卷积分析来描述F的分泌和消除情况。所有新生儿均观察到脉冲式F分泌。将8名产前暴露于糖皮质激素的新生儿（ANG组）的反卷积估计值与18名未暴露或仅远距离暴露于ANG的新生儿（No/RG组）的估计值进行比较。ANG组F分泌脉冲的中位数幅度显著低于No/RG组[分别为4.3 nmol/Lv×分钟和9.2 nmol/Lv×分钟；p = 0.026（Lv为F分布容积升）]。两组F分泌脉冲的数量和持续时间相似：每6小时5次脉冲，分别为23分钟和16分钟。通过单变量线性回归分析，平均动脉血压与F分泌脉冲频率和F生成率呈正相关（分别为p = 0.0035，r = 0.55和p = 0.0067，r = 0.52）。我们认为ANG治疗可调节早产儿脉冲式F分泌的幅度。
