在暴露于长期类固醇疗程的新生儿中预测具有阳性上腺功能缺陷:皮质醇水平有帮助吗?
Kristen Rosano1, Saya Bery2, Jaime Marasch2
1Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland, OH, USA. kristen.rosano@uhhospitals.org.
概括
长时间服用类固醇的新生儿的随机皮质醇水平不能可靠地预测二次上腺功能不足 (AI). 需要进一步测试才能在这个脆弱人群中诊断AI.
科学领域:
- 新生儿内分泌学 新生儿内分泌学
- 儿科重症监护 儿科重症监护 儿科重症监护
背景情况:
- 接受长期全身类固醇的新生儿有第二次上腺功能不全 (AI) 的风险.
- 对新生儿人工智能的准确评估对于及时干预至关重要.
研究的目的:
- 评估随机血清皮质醇水平是否可以预测先前长期暴露于类固醇的新生儿的中央AI.
主要方法:
- 对接受≥10天全身类固醇的新生儿 (2017-2022) 的回顾性分析.
- 测量皮质醇水平后的类固醇暴露,并与AI发展或失败的 adrenocorticotropic激素 (ACTH) 刺激测试相关联.
主要成果:
- 在开发AI (6.5mcg/dL) 和未开发AI (9.2mcg/dL) 的新生儿之间,没有观察到中位皮质醇水平的显著差异.
- 皮质醇水平在未通过或通过ACTH刺激测试的新生儿之间没有区别.
结论:
- 随机皮质醇测量不是在长时间暴露于类固醇后在新生儿中诊断二级AI的可靠指标.
- 在这个群体中,临床症状和正式测试对于AI诊断至关重要.
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