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系统性皮对有通风的早产婴儿的影响:随机临床试验的死亡率和5.5年神经发育结果
Tessa de Baat1, Moniek van de Loo1, Cornelieke S H Aarnoudse-Moens2
1Department of Neonatology, Emma Children's Hospital, Amsterdam UMC, Amsterdam, The Netherlands; Amsterdam Reproduction & Development research institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
The Journal of pediatrics
|December 14, 2025
概括
在早产婴儿中,皮松治疗没有改善神经发育结果,也没有降低到5.5岁时的死亡率. 这项研究发现,皮和安慰剂组之间的认知,运动或神经感官功能没有显著差异.
科学领域:
- 新生儿医学 新生儿医学
- 儿科神经学 儿科神经学
- 发育儿科 发育儿科
背景情况:
- 支气管肺功能障碍症 (BPD) 是早产婴儿的严重并发症,需要机械通风.
- 系统性皮 (HC) 的早期使用已被探索,以预防BPD和改善结果.
- 系统性皮 (HC) 预防早产婴儿肺支气管发育不良 (SToP-BPD) 研究调查了HC的疗效.
研究的目的:
- 评估SToP-BPD研究中早产婴儿在5.5岁时的神经发育结果,经过年龄校正.
- 为了比较HC治疗和安慰剂之间的神经发育结果和死亡率,在机械通风早产婴儿中.
- 为了评估出生后7至14天开始的HC的影响.
主要方法:
- 长度随访数据采集于5.5年,年龄修正.
- 评估认知,运动,神经感官功能,行为,教育和一般健康状况.
- 主要结局:死亡或中度至严重的神经发育障碍 (NDI),定义为认知,运动,视力或听力方面的缺陷.
主要成果:
- 在77%的幸存儿童中进行了NDI评估;随访参与者有更受教育/不吸烟的父母和更好的先前结果.
- 在HC和安慰剂组之间,主要结局 (死亡或中度至重度的NDI) 没有显著差异 (OR 0.75;95% CI 0.49-1.14;P = .18).
- 所有单独的发展结果,包括认知,运动和神经感官评估,在治疗手臂之间都是可比的.
结论:
- 在患有BPD风险的早产婴儿中,在7至14天之间开始的全身皮治疗没有影响5.5岁纠正年龄的死亡或中度至重度的NDI.
- 在5.5年的随访期内,HC治疗没有显著改变任何个体发育结果.
- 这些发现表明,在这个脆弱的早产儿群体中,早期HC的使用不会给长期的神经发育带来好处.
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