多疗程糖皮质激素治疗孕34周前早产临床分析

Study of the Effect of Multiple Courses of Antenatal Glucocorticoids on Preterm Birth Less than 34 Weeks

目的:评价多疗程糖皮质激素(GC)治疗孕34周前早产的作用。方法:回顾性分析华西第二医院收治的150例孕34周前早产分娩的临床资料,根据糖皮质激素治疗情况分为未治疗组(对照组)、不足1疗程组、1疗程组、2疗程组和3疗程组。结果:GC治疗组与对照组的新生儿出生体重和身长Z积分值差异无显著性(P>0.05);Logistic回归分析显示2疗程GC治疗可以减少新生儿5分钟窒息发生,但重复疗程GC治疗对新生儿RDS、脑室内出血、吸入性肺炎和婴幼儿死亡、远期并发症等无保护性作用。结论:孕34周前糖皮质激素治疗早产是有好处的,但重复疗程治疗的作用尚需进一步观察。

Objective：To evaluate the effect of multiple courses of antenatal glucocorticoids （GC） on preterm birth less than 34 weeks. Methods： A retrospective study was performed for 150 cases of preterm birth less than 34 weeks of gestation in the West China Second Hospital.The cases were divided into incomplete 1 course,1 course,2 courses,3 courses of application of antenatal glucocorticoids and control group. Results： There were no statistic significance in the Z-scores of birth weight and birth length of newborns among each GC treatment groups and the control group（ P 〉 0.05） ; Logistic analysis showed that the 2-course group had a lower risk of newborn asphyxia in 5-minute than the control group（OR,0.010;95% Cl,0.000 - 0.779） ,but repeat GC courses had no protective effect on newborn RDS, IVH,aspiration pneumonia and infant death rate as well as long-term complications.Conclusions：Antenatal glucocorticoids was beneficial to the treatment of preterm birth less than 34 weeks;however, the outcomes of multiple courses need more observation and research.