新生儿肾上腺皮质囊性变临床意义探讨

Clinical Significance of Cystic Degeneration on Adrenal Cortex in Newborns

摘要:

目的 探讨新生儿肾上腺皮质囊性变的临床意义。方法 回顾分析本院1990～1996年资料完整的70例尸检新生儿肾上腺组织形态学变化及临床资料。结果 新生儿肾上腺组织结构仍具有胎儿期特征，在29例中出现肾上腺皮质囊性变。胎龄≤36 w者，肾上腺皮质囊性变发生率高于胎龄>36 w者(60% vs 24.57%，χ2=9.95，P<0.005)；围产期窒息者肾上腺皮质囊性变发生率高于非窒息者。组织化学染色显示肾上腺皮质囊性变与永久皮质的脂质含量减少有关(P<0.05)。结论 肾上腺皮质囊性变与围产期缺氧、婴儿成熟度有关，可能为一种应激反应。

Abstract:

Objective To study the clinical signif icance of cystic degeneration in the adrenal cortex of newborns. Methods We reviewed the clinical data and morphologic changes of the adrenal c ortex of 70 newborns who died between January 1990 and December 1996. Re sults Cystic degeneration of the adrenal cortex was observed in 29 case s. There was a significantly higher incidence of cystic degeneration in infantswhose gestational age ≤36 w than those whose gestational age>36 w (60% vs 24. 57%, χ2=9.95,P<0.005). We also found a higher incidence of cys tic degeneration in asphyxiated infants than in nonasphyxiated ones. Histochem ical study showed that cystic degeneration was related to lipid depletion in the adrenal cortex. Conclusions Microcyst information in the outer adrenal cortex was associated with prematurity and perinatal hypoxia, which may be a reaction stress situation.