Study of adrenal insufficiency in preterm infants with critical lung diseases and its relationship with prognosis
10.3969/j.issn.1000-3606.2015.03.004
- VernacularTitle:危重肺部疾病早产儿肾上腺皮质功能不全及其与预后的关系
- Author:
Jinliang LI
;
Qiang GU
;
Bo YUAN
- Publication Type:Journal Article
- Keywords:
critical lung diseases;
cortisol;
adrenal insufifciency;
preterm infant
- From:
Journal of Clinical Pediatrics
2015;(3):214-217
- CountryChina
- Language:Chinese
-
Abstract:
ObjectiveTo explore adrenal insufficiency in the preterm infants who had critical lung diseases and the relationship between adrenal insufifciency and long-term or short-term prognosis.Methods The basal cortisol and ACTH of iffty preterm infants enrolled were tested. The peak cortisol at 30 minutes after low dose ACTH stimulation was tested. The adrenal insufifciency was deifned as the concentration of the basal cortisol less than 15 μg/dl or the increment of cortisol concentration after low dose ACTH stimulation less than 9 μg/dl. The pretern infants with adrenal insufifciency were the AI group and others were the adrenal normality, AN group.Results Thirty-one cases were adrenal insufifciency in 50 preterm infants with critical lung disease. The incidence was 62%. The concentrations of the basal and peak cortisol in AI group were lower than those in AN group (P<0.01). The increment of cortisol concentration after low dose ACTH stimulation had not signiifcant difference between two groups. The concentration of ACTH in AI group was lower than that in AN group (P<0.01). The mean arterial blood pressure in AI group was lower than that in AN group (P<0.01). The blood sugar, potassium and sodium had no signiifcant difference between two groups (P>0.05). There was no signiifcant difference in the mortality and the incidence of BPD between two groups (P>0.05).Conclusions The incidence of adrenal insufifciency was high in the preterm infants with critical lung diseases, which may be due to insufifcient production of endogenous ACTH. When the adrenal insufifciency was happened, the blood pressure is relatively low in preterm infants with critical lung diseases, but it was not related to the mortality and the incidence of BPD.