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請使用永久網址來引用或連結此文件:
http://ir.cmu.edu.tw/ir/handle/310903500/27159
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| 題名: | Early dexamethasone therapy in preterm infants: A follow-up study |
| 作者: | Yeh, TF;Lin, YJ;Huang, CC;Chen, YJ;Lin, CH;Lin, HC;Hsieh, WS;Lien, YJ |
| 貢獻者: | 附設醫院
Natl Cheng Kung Univ Hosp, Dept Pediat, Tainan, Taiwan;China Med Coll Hosp, Taichung, Taiwan;Chang Gung Childrens Hosp, Taipei, Taiwan |
| 日期: | 1998 |
| 上傳時間: | 2010-09-20 13:54:59 (UTC+8) |
| 出版者: | AMER ACAD PEDIATRICS |
| 摘要: | Objectives. To study the outcome at 2-year corrected age of infants who participated in a double-blind controlled trial of early (<12 hours) dexamethasone therapy for the prevention of chronic lung disease (CCD). Methods and Materials. A total of 133 children (70 in the control group, 63 in the dexamethasone-treated group) who survived the initial study period and lived to 2 years of age were studied. All infants had birth weights of 500 to 1999 g and had severe respiratory distress syndrome requiring mechanical ventilation within 6 hours after birth. For infant's in the treatment group, dexamethasone was started at a mean age of 8.1 hours and given 0.25 mg/kg every 12 hours for 1 week and then tapered off gradually over a 3-week period. The following variables were evaluated: interim medical history, socioeconomic background, physical growth, neurologic examinations, mental and psychomotor development index score (MDI and PDD, pulmonary function, electroencephalogram, and auditory and visual evoked potential. Results. Infants in the control group tended to have a higher incidence of upper respiratory infection and rehospitalization than did the dexamethasone-treated group because of respiratory problems. Although there was no difference between the groups in somatic growth in girls, the dexamethasone-treated boys had significantly lower body weight and shorter height than the control boys (10.7 +/- 3.0 vs 11.9 +/- 2.0 kg; 84.9 +/- 5.7 vs 87.5 +/- 4.8 cm). The dexamethasone-treated group had a significantly higher incidence of neuromotor dysfunction (25/63 vs 12/70) than did the control group. The dexamethasone-treated infants also had a lower PDI score (79 +/- 26) than did the control group (87 +/- 23), but the difference was not statistically significant. Both groups were comparable in MDI, incidence of vision impairment, and auditory and visual evoked potential. Significant handicap, defined as severe neurologic defect and/or intellectual defect (MDI and/or PDI less than or equal to 69), was seen in 22 children (31.4%) in the control group and 26 (41.2%) in the dexamethasone-treated group. Conclusions. Although early postnatal dexamethasone therapy for 4 weeks significantly reduces the incidence of CLD, this therapeutic regimen cannot be recommended at present because of its adverse effects on neuromotor function and somatic growth in male infants, detected at 2 years of age. A longer follow-up is needed. If early dexamethasone therapy is to be used for the prevention of CLD, the therapeutic regimen should be modified. The proper route of administration, the critical time to initiate the therapy, and the dosage and duration of therapy remain to be defined further. |
| 關聯: | PEDIATRICS 101(5):art. no.-e7 |
| 顯示於類別: | [台中附設醫院] 會議論文
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