Year 2016,
Volume: 6 Issue: 3, 0 - 0, 01.09.2016
Abstract
Amaç: Respiratuvar distres sendromu (RDS), prematüre bebeklerde morbidite ve mortalitenin en önemli nedenidir. RDS 'nin gelişmesinde en önemli faktör gestasyonel yaş olmakla birlikte bazı maternal ve fetal faktörler de hastalığın gelişmesinde etkilidir. Steroidlerin c-AMP (siklik adenozin monofosfat) yolu ile sürfaktan yapımını ve doğum eylemi sırasında sürfaktan sekresyonunu stimüle ettiği bilinmektedir. Bazı prematüre bebeklerde RDS gelişmemektedir. Bu hastalığın postnatal seyrinin bebeğin strese endojen cevabı ile ilişkili olma ihtimalini düşündürmektedir. Bu çalışmada, RDS gelişen bebeklerin stres karşısında endojen kortizol yanıtları araştırıldı.
Gereç ve Yöntemler: Gestasyonel yaşları 28-35 hafta arasında değişen respiratuvar distres sendromlu 20 bebek, hafif solunum distresli 19 bebek ve sağlıklı 25 bebekte postnatal 2-8. saatte ve 2.gün kortizol düzeyleri çalışıldı.
Bulgular: RDS grubunda ortalama 1.kortizol düzeyi (52.90± 57.47 μg/dl), kontrol grubuna (29.51± 13.52 μg/dl) göre daha yüksekti ve bu bulgular istatistiksel olarak anlamlı idi (P<0.05). Benzer şekilde, hafif RDS grubunda da ortalama 1.kortizol düzeyleri (71.61± 81.97 μg/dl) kontrol grubundan anlamı olarak daha yüksekti (P<0.05). Postnatal 2.günde kortizol düzeylerinin RDS'li bebeklerde stresin artmasına bağlı yükselirken (71.14± 79.04 μg/dl) kontrol grup ve hafif solunum distresi olan bebeklerde (sırasıyle, 22.09±11.29 ve 45.12± 41.11μg/dl) stresin azalmasıyla düştüğü gözlendi..
Sonuç: Bu bulgular prematüre bebeklerde strese endojen kortizol yanıtının oldukça iyi olduğunu, RDS’nin kortizol yanıtı ile doğrudan ilişkili olmadığını göstermektedir.
References
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- Plasma mineralocorticoids, glucocorticoids, and progesting in premature infants: Longitudinal study during the first week of life Pediatr Res 1988; 23:525-529. 20. Lee MM, Rajagopalan L, Berg GJ, Moshang T Jr.Serum adrenal steroid concentrations in premature infants. J Clin Endocrinol Metab 1989;63: 1133-1136. 21. Thomas S,Murhpy JF,Dyas J, Ryalllas M, Hughes IA. Responce to ACTH in the nevborn. Arc Dis Child 1986; 61: 57-60. 22. Noguchi A, Reynolds JW. Serum cortisol and dehydroepiandrosterone sulfate responses to adrenocorticotropin stimulation in prematüre infabts. Pediatr Res 1978; 12: 1057-1061. 23. Hughes D, Murphy JF, Dyas J, Robinson JA, Riad-Fahmy Dr, Hughes IA.Blood spot glucocorticoid concentrations in ill preterm infants.Arch Dis Child 1987; 62: 1014-1018. 24. Reynold JW. Total serum corticoid and cortisol levels in prematur infants whit RDS. Pediatrics 1973; 51: 881-890
Year 2016,
Volume: 6 Issue: 3, 0 - 0, 01.09.2016
Abstract
References
- Oran O.Respiratuvar distres sendromu:Sürfaktan tedavisi. İn:Oran o, Erdem G,Tekinalp G,Yurdakök M(eds), Yenidoğan Akciğer Hastalıkları.Güneş Yayınları,Ankara 1992, ss 1869-194. 2. Farrel PM, Avery ME. Hyaline membrane disease.Am Rev Respir Dis 1975; 111:657-688 3. Usher RH, Allen AC,Mc Lean FH: Risk of respiratory distress syndrome related to gestational age, route of delivery, and maternal diabetes. Am J Obstet Gynecol 1971; 111:826832 4. Milner AD, Sürfaktan ve respiratuar distires sendromu. Çocuk Sağlığı ve Hastalıkları Dergisi 1996;37:37-43. 5. Bolt R J, van Weissenbruch M M, Popp-Snijders C, Sweep C G, Lafeber H N, Delemarre-van de Waal H A. Fetal growth and the function of the adrenal cortex in preterm infants. J Clin Endocrinol Metab. 2002; 87 1194-1199 6. Heckmann M, Wudy S A, Haack D, Pohlandt F. Serum cortisol concentrations in ill preterm infants less than 30 weeks gestational age. Acta Paediatr. 2000; 89 10981103 . 7. Economou G, Andronikou S, Challa A, Cholevas V, Lapatsanis P D. Cortisol secretion in stressed babies during the neonatal period. Horm Res. 1993; 40 217-221. 8. Sümbüllüoğlu K, Sümbüllüoğlu V. Biyoistatistik(1.Baskı). Çağ matbaası, Ankara 1987;ss48-178 9. Chiswick ML. Prolonged rüptüre of membranes, preeclamptic toxaemia, and respiratory distrees syndrome. Arch Dis Child 1976;51:674-679 10. Murphy BEP, Patrick J, Denton RL.Cortisol in amniotic fluid during human gestation. J Clın Ebdocrinol Metab 1975;40:164-167. 11. Murhpy BEP. Human fetal serum cortisol levels related to gestational age: Evidence of a midgestational fall and a steep late gestational rise,independet of sex or mode of delivery. Am J Obstet Gynecol 1982;144:276-282. 12. Sybulsky S, Maughan GB. Relationship between cortisol levels in umblical cord plasma and development of the RDS in prematüre newborn infants Am J Obstet Gynecol 1976;125:239. 13. Srivastava T,Merchant RH, Ambadekar MC. Cord cortisol levels and respiratory distress syndrome.İndian Pediatrisc 1994;31:923-928 14. Smith BT, Worthington D, Maloney AH.Fetal lung maturation.L11.The amniotich fluid cortisol/cortison ratio in pretern human delivery and the risk of respiratory distitress syndrome.Obstet Gynecol 1977;49(5):527-531. 15. Gunes T, Koklu E, Ozturk MA, Koklu S, Cetin N. Evaluation of serum cortisol levels in a relatively large and mature group of ventilated and nonventilated preterm infants with respiratory distress syndrome. Am J Perinatol. 2006;23:335-9 16. Kauppila A, Koivisto M, Pukka M, Tuimala R, Umblical cord and neonatal cortisol levels. Effect of gestational and neonatal factors.Obstet Gynecol 1972;52:666-672. 17. Ballard PL. Hormonal regülation of pulmonary surfactant. Endocr Rev 1989;10: 161-181. 18. Kraiem Z, Sack J, Brish M. Serum cortisol levels: The first 10 days in full- term and preterm infants.İsrael J Med Sci 1985;21: 170-172 19. Doerr H, Sippell WG, Versmold HT, Bidlingmaier F, Knorr D.
- Plasma mineralocorticoids, glucocorticoids, and progesting in premature infants: Longitudinal study during the first week of life Pediatr Res 1988; 23:525-529. 20. Lee MM, Rajagopalan L, Berg GJ, Moshang T Jr.Serum adrenal steroid concentrations in premature infants. J Clin Endocrinol Metab 1989;63: 1133-1136. 21. Thomas S,Murhpy JF,Dyas J, Ryalllas M, Hughes IA. Responce to ACTH in the nevborn. Arc Dis Child 1986; 61: 57-60. 22. Noguchi A, Reynolds JW. Serum cortisol and dehydroepiandrosterone sulfate responses to adrenocorticotropin stimulation in prematüre infabts. Pediatr Res 1978; 12: 1057-1061. 23. Hughes D, Murphy JF, Dyas J, Robinson JA, Riad-Fahmy Dr, Hughes IA.Blood spot glucocorticoid concentrations in ill preterm infants.Arch Dis Child 1987; 62: 1014-1018. 24. Reynold JW. Total serum corticoid and cortisol levels in prematur infants whit RDS. Pediatrics 1973; 51: 881-890
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Details
| Journal Section | Articles |
|---|---|
| Authors | |
| Publication Date | September 1, 2016 |
| Submission Date | September 16, 2016 |
| Published in Issue | Year 2016 Volume: 6 Issue: 3 |
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