早产儿使用地塞米松有害无益
路透社纽约健康消息 最新研究警告说，常规用于早产儿的一种激素──地塞米松，不但不能预防早产儿肺病，相反对早产儿有损害。
早产儿，特别是出生体重低于1千克的，出现慢性肺部疾病风险很高，需要额外多的氧气。通常医生会给他们使用地塞米松，目的是预防慢性肺部疾病的发生。为了确定地塞米松是否确实对早产儿有益，美国国家儿童健康与发育研究所新生儿研究网络的成员，波士顿布来汉姆和妇女医院的研究人员进行了一项研究，论文发表在近期《新英格兰医学杂志》上。
这项研究中一共观察了220名早产儿，结果发现，早期中等剂量的地塞米松治疗既不能增加早产儿的生存率，也不能预防慢性肺部疾病，反而有可能威胁其健康。用地塞米松治疗的早产儿比未治疗的早产儿患并发症的危险性更大，这些并发症包括高血压、需要注射胰岛素治疗的高血糖以及发育迟缓。更重要的是，接受地塞米松治疗的早产儿更容易出现发育迟缓和自发性肠穿孔，这也是导致该临床试验提前中断的主要原因。
, http://www.100md.com
因此论文作者建议：对极低体重儿没有必要早期应用地塞米松治疗来预防慢性肺部疾病。
来源：《新英格兰医学杂志》2001;344:95-101
Commonly Used Drug Puts Premature Infants at Risk
NEW YORK -- Dexamethasone, an anti-inflammatory drug commonly given to very premature infants, does not protect them against lung disease and may, in fact, harm them, researchers warn.
The risk to these infants was so great that the trial was stopped early, prompting Dr. Duane Alexander, director of the National Institute of Child Health and Human Development (NICHD) to say in a statement, "This study shows that early moderate doses of dexamethasone do not increase the survival of preterm infants or prevent chronic lung disease and may actually endanger their health."
, 百拇医药
Premature infants, especially those weighing less than 1 kilogram (about 2 pounds) at birth, face a high risk of developing chronic lung disease, and require supplemental oxygen to breathe, according to Dr. Ann R. Stark from Brigham and Women‘s Hospital in Boston, Mass., and associates. Dexamethasone is often given in hopes of preventing chronic lung disease.
The authors, part of the NICHD Neonatal Research Network, conducted a formal study to determine whether dexamethasone actually helps these premature infants.
, http://www.100md.com
In the study, which looked at 220 premature infants, dexamethasone treatment had no real effect on the risk of death or chronic lung disease, according to the report in the Jan. 11 issue of The New England Journal of Medicine.
In fact, the researchers report, infants treated with dexamethasone were more likely than untreated infants to develop complications, including high blood pressure, high blood sugar requiring insulin injections and decreased growth. Most importantly, infants receiving dexamethasone were more likely to suffer decreased growth and spontaneous perforations to their intestines. This was the complication that caused the early stoppage of the trial.
"Given these serious complications and the lack of a discernible benefit," the authors conclude, "we believe that early treatment with dexamethasone to prevent chronic lung disease in extremely low birth weight infants is not indicated."
SOURCE: The New England Journal of Medicine 2001;344:95-101., 百拇医药
早产儿，特别是出生体重低于1千克的，出现慢性肺部疾病风险很高，需要额外多的氧气。通常医生会给他们使用地塞米松，目的是预防慢性肺部疾病的发生。为了确定地塞米松是否确实对早产儿有益，美国国家儿童健康与发育研究所新生儿研究网络的成员，波士顿布来汉姆和妇女医院的研究人员进行了一项研究，论文发表在近期《新英格兰医学杂志》上。
这项研究中一共观察了220名早产儿，结果发现，早期中等剂量的地塞米松治疗既不能增加早产儿的生存率，也不能预防慢性肺部疾病，反而有可能威胁其健康。用地塞米松治疗的早产儿比未治疗的早产儿患并发症的危险性更大，这些并发症包括高血压、需要注射胰岛素治疗的高血糖以及发育迟缓。更重要的是，接受地塞米松治疗的早产儿更容易出现发育迟缓和自发性肠穿孔，这也是导致该临床试验提前中断的主要原因。
, http://www.100md.com
因此论文作者建议：对极低体重儿没有必要早期应用地塞米松治疗来预防慢性肺部疾病。
来源：《新英格兰医学杂志》2001;344:95-101
Commonly Used Drug Puts Premature Infants at Risk
NEW YORK -- Dexamethasone, an anti-inflammatory drug commonly given to very premature infants, does not protect them against lung disease and may, in fact, harm them, researchers warn.
The risk to these infants was so great that the trial was stopped early, prompting Dr. Duane Alexander, director of the National Institute of Child Health and Human Development (NICHD) to say in a statement, "This study shows that early moderate doses of dexamethasone do not increase the survival of preterm infants or prevent chronic lung disease and may actually endanger their health."
, 百拇医药
Premature infants, especially those weighing less than 1 kilogram (about 2 pounds) at birth, face a high risk of developing chronic lung disease, and require supplemental oxygen to breathe, according to Dr. Ann R. Stark from Brigham and Women‘s Hospital in Boston, Mass., and associates. Dexamethasone is often given in hopes of preventing chronic lung disease.
The authors, part of the NICHD Neonatal Research Network, conducted a formal study to determine whether dexamethasone actually helps these premature infants.
, http://www.100md.com
In the study, which looked at 220 premature infants, dexamethasone treatment had no real effect on the risk of death or chronic lung disease, according to the report in the Jan. 11 issue of The New England Journal of Medicine.
In fact, the researchers report, infants treated with dexamethasone were more likely than untreated infants to develop complications, including high blood pressure, high blood sugar requiring insulin injections and decreased growth. Most importantly, infants receiving dexamethasone were more likely to suffer decreased growth and spontaneous perforations to their intestines. This was the complication that caused the early stoppage of the trial.
"Given these serious complications and the lack of a discernible benefit," the authors conclude, "we believe that early treatment with dexamethasone to prevent chronic lung disease in extremely low birth weight infants is not indicated."
SOURCE: The New England Journal of Medicine 2001;344:95-101., 百拇医药
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