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目的探讨产前不同疗程激素治疗对早产儿脑发育的影响。方法 28~34周的早产儿107例,按母亲产前应用地塞米松的情况分为对照组(n=32)、单疗程组(n=45)、多疗程组(n=30)。对照组未用地塞米松;单疗程组应用地塞米松6 mg,2次/d,肌内注射,2 d为1个疗程,仅用1个疗程;多疗程组应用地塞米松1个疗程以上。纠正胎龄至预产期时行新生儿20项行为神经测定(NBNA),纠正胎龄至出生6、12个月时采用Beylay婴幼儿发展量表的智力发展指数(MDI)和精神运动发展指数(PDI)进行婴幼儿期智能发育评估。结果纠正胎龄达预产期时单疗程组NBNA评分明显高于对照组及多疗程组(P<0.05)。纠正胎龄至出生6、12个月行Beylay婴幼儿发展量表检测,单疗程组MDI和PDI均明显高于对照组及多疗程组(P<0.05)。结论产前单疗程地塞米松治疗可改善早产儿近、远期预后;产前多疗程地塞米松治疗对早产儿脑发育有一定的不良影响,临床应用时应提高警惕。
Objective To investigate the effect of hormonal therapy with prenatal different courses on brain development in premature infants. Methods A total of 107 preterm infants between 28 and 34 weeks were divided into control group (n = 32), single treatment group (n = 45) and multiple treatment group (n = 30) according to the prenatal application of dexamethasone. The control group did not use dexamethasone; single-treatment group dexamethasone 6 mg, 2 times / d, intramuscular injection, 2 d for a course of treatment, only one course of treatment; multiple courses of treatment with dexamethasone more than 1 course of treatment . 20 Behavioral Nerves Test (NBNA) of newborns were corrected at gestational age to the expected date of birth and the Beylay Infants Development Scale (MDI) and Psychomotor Development Index (PDI) ) For early childhood intelligence development assessment. Results Correction of gestational age at the expected date of single-course NBNA score was significantly higher than the control group and multi-treatment group (P <0.05). Correct gestational age to 6,12 months of birth line Beylay infant development scale test, single-treatment group MDI and PDI were significantly higher than the control group and multi-treatment group (P <0.05). Conclusion Prenatal dexamethasone treatment can improve short-term and long-term prognosis of preterm infants. Prenatal multi-course dexamethasone treatment has some adverse effects on brain development in preterm infants, and should be vigilant in clinical application.