产前应用倍他米松或地塞米松对早产儿神经发育的影响研究

The influence research of antenatal Betamethasone or Dexamethasone on neurological development of preterm children

目的探讨产前应用倍他米松或地塞米松治疗对早产儿神经发育的影响。方法选择我院2008年1月～2011年1月收治的28～34周的早产儿200例,按照母亲产前是否应用倍他米松或地塞米松治疗的情况分为两组,对照组100例未用倍他米松或地塞米松治疗;观察组给予倍他米松或地塞米松治疗1～2个疗程,两组早产儿出生后均给予对症支持治疗。并对早产儿出生3、6、12个月的智力发育指数(MDI)和运动发育指数(PDI)量表进行检测。结果观察组早产儿胎龄平均(34.73±2.01)周,对照组为(34.59±1.98)周,两组比较差异无统计学意义(P>0.05);观察组早产儿体质包括出生体重、身长、头围、胸围等指标与对照组比较差异无统计学意义(P>0.05);观察组早产儿窒息、缺血缺氧性脑病(HIE)和颅内出血的发生率与对照组比较,差异无统计学意义(P>0.05);观察组第1天的Brazelton评分与对照组比较差异无统计学意义(P>0.05);第5天的Brazelton评分,观察组明显高于对照组,差异有统计学意义(P<0.05);两组早产儿中观察组3、6、12个月智力发育指数和运动发育指数明显高于对照组,差异有统计学意义(P<0.05)。结论产前孕妇应用倍他米松或地塞米松治疗可促进早产儿神经发育,改善脑功能。

Objective To investigate the influence of antenatal Betamethasone or Dexamethasone on neurological development of preterm children.Methods 200 cases of premature infants of 28-34 weeks admitted to our hospital from January 2008 to January 2011 were selected,all the infants were divided into two groups according to the prenatal application of Betamethasone or Dexamethasone of mother,100 cases of control group with no Betamethasone or Dexamethasone treatment;100 cases of control group with Betamethasone or Dexamethasone treatment for 1-2 courses;two groups of preterm children were all given symptomatic and supportive treatment after born.And preterm children were detected with mental development index（MDI） and psychomotor development index（PDI） in the 3,6,12 months after born.Results The average gestational age in preterm children of the observation group was（34.73±2.01） weeks,which of the control group was（34.59±1.98） weeks,there was no significant difference（P 0.05）;the physical indicators of birth weight,length,head circumference,chest circumference of preterm children in observation group compared with control group,the difference was not significant different（P 0.05）;incidence of preterm children suffocation,HIE and intracranial hemorrhage of observation group compared with the control group,the difference was not significant（P 0.05）;the Brazelton score of the first day compared with control group,the difference was not significant（P 0.05）;Brazelton score of the fifth day of observation group was significantly higher than control group（P 0.05）;mental development index and psychomotor development index in 3,6 and 12 months of observation group was significantly higher than control group（P 0.05）.Conclusion The prenatal Betamethasone or Dexamethasone treatment of pregnant women may promote neurological development in preterm children,and improve brain function.