糖皮质激素促肺成熟作用的研究进展

Glucocorticoid in promoting fetal/neonatal lung maturity

大量研究证实围生期使用糖皮质激素可促进肺成熟,显著降低新生儿呼吸窘迫综合征的发病率和病死率.其作用机制主要是促进肺泡发育和肺表面活性物质系统的成熟.同时,围生期使用糖皮质激素对胎儿和新生儿造成的不良影响正受到越来越多的关注.产前重复使用糖皮质激素和生后早期静脉使用糖皮质激素的安全性仍不确定.糖皮质激素的给药途径、不同剂量糖皮质激素的作用效果和机制仍需深入研究.该文对近年来产前使用糖皮质激素和新生儿早期使用糖皮质激素促肺成熟作用的临床研究和动物实验研究进行综述.

Perinatal glucocorticoid therapy has been proved to be effective on promoting fetal/neonatal lung maturity and has contributed to a dramatic improvement in the mortality and morbidity associated with neonatal respiratory distress syndrome.The underlying mechanisms studies are aimed primarily at accelerating the development of alveoli and pulmonary surfactant system.Meanwhile,a growing number of investigations focus on the side effects of perinatal glucocorticoid therapy on fetal/neonatal.Whether the repeat antenatal glucocorticoid and early postnatal glucocorticoid by intravenous injection is safe remains unclear.More studies are needed on the different route of giving glucocorticoid,the effect of different doses and their machanisms.This review presents the relevant information surrounding perinatal glucocorticoid therapy to enhance fetal/neonatal lung maturity,including clinical and animal studies over the last decades.