脓毒症新生儿肾上腺皮质功能的研究.doc

上海交通大学硕士学位论文 ADRENAL FUNCTION IN NOEONATES WITH SEPSIS ABSTRACT Objective To observe the adrenal function in neonates with sepsis, the incidence of adrenal insufficiency in neonates with sepsis, and explore the relationships between adrenal function and severity of sepsis. Method 80 neonates (gestational age ≥36w) were selected from shanghai children hospital, these neonates were divided into 2 group consisting of 20 neonates ( as control group) and 60 neonates with sepsis (as experimental group) respectively. 60 neonates with sepsis were subdivided into 2 group according to whether they are severe sepsis , severe sepsis (SS) group consisted of 11 neonates and sepsis (S) group consisted of 49 neonates. The venous blood samples were collected and 30 minutes after low-dose ACTH stimulation test respectively. The serum cortisol levels were measured by chemiluminescence immunoassay. Results 1. Control group: the mean basal serum cortisol level was ug/dl (95%CI 7.91~13.34ug/dl), the mean peak serum cortisiol level 4 上海交通大学硕士学位论文 after low-dose ACTH test was 31.51ug/dl (95%CI 27.88~35.14ug/dl); experimental group: the mean basal serum cortisol level was 31.64ug/dl (95%CI 25.29~36.93ug/dl), the mean peak serum cortisiol level after low-dose ACTH test was 47.63ug/dl (95%CI 42.56~52.71ug/dl); The mean basal serum cortisol level of experimental group was significantly higher than that of the control group (P=0.0001＜0.01), The mean peak serum cortisol level of the experimental group was significantly higher than that of the control group (P=0.0001＜0.01). 2. S group: the mean basal serum cortisol level was 23.24ug/dl (95%CI 18.22~28.27ug/dl), the mean peak serum cortisiol level after low-dose ACTH test was ug/dl (95%CI 37.36~46.73ug/dl); SS group: the mean basal serum cortisol level was 51.89ug/dl (95%CI 33.26~70.51ug/dl), the mean peak serum cortisiol level after low-dose ACTH test was 60.36ug/dl (95%CI ~75.12ug/dl); The mean basal serum cortisol level of SS group was signific