{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T19:51:50Z","timestamp":1785527510218,"version":"3.56.0"},"reference-count":57,"publisher":"Akademiai Kiado Zrt.","issue":"24","license":[{"start":{"date-parts":[[2025,6,15]],"date-time":"2025-06-15T00:00:00Z","timestamp":1749945600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Eur\u00f3pai Uni\u00f3 Helyre\u00e1ll\u00edt\u00e1si \u00e9s Ellen\u00e1ll\u00f3k\u00e9pess\u00e9gi Eszk\u00f6z","award":["RRF-2.3.121-2022-00011"],"award-info":[{"award-number":["RRF-2.3.121-2022-00011"]}]},{"DOI":"10.13039\/501100011019","name":"Nemzeti Kutat\u00e1si, Fejleszt\u00e9si \u00e9s Innov\u00e1ci\u00f3s Hivatal","doi-asserted-by":"crossref","award":["OTKA PD 142288"],"award-info":[{"award-number":["OTKA PD 142288"]}],"id":[{"id":"10.13039\/501100011019","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100011019","name":"Nemzeti Kutat\u00e1si, Fejleszt\u00e9si \u00e9s Innov\u00e1ci\u00f3s Hivatal","doi-asserted-by":"crossref","award":["TKP2021-EGA25"],"award-info":[{"award-number":["TKP2021-EGA25"]}],"id":[{"id":"10.13039\/501100011019","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["www.akjournals.com"],"crossmark-restriction":true},"short-container-title":["OH"],"published-print":{"date-parts":[[2025,6,15]]},"abstract":"<jats:p>\n                    <jats:italic>Bevezet\u00e9s:<\/jats:italic>\n                    A perinatalis asphyxi\u00e1t \u00e1t\u00e9lt, hypothermi\u00e1s\n                    kezel\u00e9sben r\u00e9szes\u00fcl\u0151 \u00fajsz\u00fcl\u00f6ttek 16%-\u00e1ban ter\u00e1piarezisztens hypotensio alakulhat\n                    ki. Etiol\u00f3giai faktork\u00e9nt felmer\u00fcl a relat\u00edv mell\u00e9kvesek\u00e9reg-el\u00e9gtelens\u00e9g, amely\n                    az \u00e1t\u00e9lt stressz m\u00e9rt\u00e9k\u00e9hez k\u00e9pest el\u00e9gtelen kortizoltermel\u00e9st jelent. A\n                    hidrokortizon szupplement\u00e1ci\u00f3ja ezekben az esetekben oki ter\u00e1pi\u00e1t jelenthet, a\n                    h\u0171t\u00e9s ideje alatt sz\u00fcks\u00e9ges d\u00f3zist azonban kor\u00e1bban nem vizsg\u00e1lt\u00e1k. Hab\u00e1r a\n                    sz\u00e9rumkortizolszint m\u00e9r\u00e9se alkalmas a ter\u00e1pia k\u00f6vet\u00e9s\u00e9re, az eredm\u00e9nyek\n                    \u00e9rt\u00e9kel\u00e9s\u00e9t nehez\u00edti, hogy a kortizolszintet feltehet\u0151en az asphyxi\u00e1s inzultus\n                    sz\u00f6v\u0151dm\u00e9nyek\u00e9nt fell\u00e9p\u0151 sokszervi m\u0171k\u00f6d\u00e9szavar, illetve a hypothermi\u00e1s kezel\u00e9s\n                    gy\u00f3gyszer-metabolizmusra gyakorolt hat\u00e1sa is befoly\u00e1solja.\n                    <jats:italic>C\u00e9lkit\u0171z\u00e9s:<\/jats:italic>\n                    Kutat\u00e1sunk c\u00e9lja volt a sz\u00e9rumkortizolszintek\n                    elemz\u00e9se perinatalis asphyxi\u00e1t \u00e1t\u00e9lt, h\u0171t\u00f6tt \u00fajsz\u00fcl\u00f6ttekben a\n                    hidrokortizon-szupplement\u00e1ci\u00f3 el\u0151tt \u00e9s alatt, valamint e szintek vizsg\u00e1lata a\n                    sokszervi m\u0171k\u00f6d\u00e9szavar s\u00falyoss\u00e1g\u00e1val \u00f6sszef\u00fcgg\u00e9sben.\n                    <jats:italic>M\u00f3dszer:<\/jats:italic>\n                    Retrospekt\u00edv kohorszvizsg\u00e1latunkba olyan, asphyxi\u00e1t \u00e1t\u00e9lt, hypothermi\u00e1s\n                    kezel\u00e9sben \u00e9s hidrokortizon-szupplement\u00e1ci\u00f3ban r\u00e9szes\u00fcl\u0151 \u00fajsz\u00fcl\u00f6tteket vontunk\n                    be, akiket a Semmelweis Egyetem Gyermekgy\u00f3gy\u00e1szati Klinik\u00e1j\u00e1nak \u00dajsz\u00fcl\u00f6tt\n                    Intenz\u00edv Centrum\u00e1ban kezeltek 2007. janu\u00e1r \u00e9s 2022. december k\u00f6z\u00f6tt. \u00c9rt\u00e9kelt\u00fck\n                    a sz\u00e9rumkortizolszinteket, illetve a sokszervi m\u0171k\u00f6d\u00e9szavar s\u00falyoss\u00e1g\u00e1t jelz\u0151\n                    param\u00e9tereket.\n                    <jats:italic>Eredm\u00e9nyek:<\/jats:italic>\n                    \u00d6sszesen 44 \u00fajsz\u00fcl\u00f6tt adatait (126\n                    db kortizolszint) elemezt\u00fck. Az endog\u00e9nkortizol-sz\u00e9rumszintek k\u00e9tharmada\n                    alacsonyabb volt a relat\u00edv mell\u00e9kvesek\u00e9reg-el\u00e9gtelens\u00e9g diagnosztikus\n                    hat\u00e1r\u00e9rt\u00e9k\u00e9n\u00e9l: 15 \u00b5g\/dl-n\u00e9l (medi\u00e1n 4,6 [IQR: 2,8; 17,1] \u00b5g\/dl). A\n                    hidrokortizon-kezel\u00e9st k\u00f6vet\u0151en szignifik\u00e1ns kortizolszint-emelked\u00e9st tal\u00e1ltunk\n                    (medi\u00e1n 61,2 [30,6; 93,4] \u00b5g\/dl; p&lt;0,001), \u00e9s a szint a ter\u00e1pia ideje alatt\n                    tov\u00e1bb emelkedett (medi\u00e1n 77,6 [46,1; 171,3] \u00b5g\/dl; p = 0,002). Megfigyelt\u00fck,\n                    hogy s\u00falyosabb sokszervi m\u0171k\u00f6d\u00e9szavart \u00e1t\u00e9l\u0151 betegekben mind az\n                    endog\u00e9nkortizol-szintek, mind a hidrokortizon-ter\u00e1pia alatt m\u00e9rt kortizolszintek\n                    szignifik\u00e1nsan magasabbak voltak.\n                    <jats:italic>Megbesz\u00e9l\u00e9s:<\/jats:italic>\n                    Az alacsony\n                    sz\u00e9rumkortizolszint j\u00f3l korrig\u00e1lhat\u00f3 hidrokortizon-p\u00f3tl\u00e1ssal, relat\u00edv\n                    mell\u00e9kvesek\u00e9reg-el\u00e9gtelens\u00e9g gyan\u00faja eset\u00e9n, perinatalis asphyxi\u00e1t \u00e1t\u00e9lt,\n                    hypothermi\u00e1s kezel\u00e9sben r\u00e9szes\u00fcl\u0151 \u00fajsz\u00fcl\u00f6ttekben. A s\u00falyosabb sokszervi\n                    m\u0171k\u00f6d\u00e9szavar eset\u00e9n tapasztalt magasabb kortizolszintek h\u00e1tter\u00e9ben a hormon\n                    fokozott termel\u00e9se, illetve a gy\u00f3gyszer cs\u00f6kkent metabolizmusa \u00e9s kiv\u00e1laszt\u00e1sa\n                    \u00e1llhat.\n                    <jats:italic>K\u00f6vetkeztet\u00e9s:<\/jats:italic>\n                    A hidrokortizon-ter\u00e1pia optimaliz\u00e1l\u00e1sa\n                    kiemelt jelent\u0151s\u00e9g\u0171 az asphyxi\u00e1t \u00e1t\u00e9lt, h\u0171t\u00f6tt \u00fajsz\u00fcl\u00f6ttekben, ez\u00e9rt tov\u00e1bbi, a\n                    sokszervi m\u0171k\u00f6d\u00e9szavar s\u00falyoss\u00e1g\u00e1t is figyelembe vev\u0151 prospekt\u00edv\n                    farmakokinetikai kutat\u00e1sok elv\u00e9gz\u00e9se sz\u00fcks\u00e9ges. Orv Hetil. 2025; 166(24):\n                    942\u2013952.\n                  <\/jats:p>","DOI":"10.1556\/650.2025.33317","type":"journal-article","created":{"date-parts":[[2025,6,17]],"date-time":"2025-06-17T20:47:39Z","timestamp":1750193259000},"page":"942-952","update-policy":"https:\/\/doi.org\/10.1556\/policypage.crossmark.crossref.2","source":"Crossref","is-referenced-by-count":1,"title":["A sz\u00e9rumkortizolszintek \u00e9s a sokszervi m\u0171k\u00f6d\u00e9szavar \u00f6sszef\u00fcgg\u00e9se oxig\u00e9nhi\u00e1nyt \u00e1t\u00e9lt \u00fajsz\u00fcl\u00f6ttekben"],"prefix":"10.1556","volume":"166","author":[{"given":"Ram\u00f3na","family":"Kerekes","sequence":"first","affiliation":[{"name":"Semmelweis Egyetem, \u00c1ltal\u00e1nos Orvostudom\u00e1nyi Kar, Neonatol\u00f3giai Tansz\u00e9k, Gyermekgy\u00f3gy\u00e1szati Klinika, MTA Kiv\u00e1l\u00f3 Kutat\u00f3hely Budapest, B\u00f3kay J\u00e1nos u. 53\u201354., 1083 Magyarorsz\u00e1g"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marianna","family":"Dobi","sequence":"additional","affiliation":[{"name":"Semmelweis Egyetem, \u00c1ltal\u00e1nos Orvostudom\u00e1nyi Kar, Neonatol\u00f3giai Tansz\u00e9k, Gyermekgy\u00f3gy\u00e1szati Klinika, MTA Kiv\u00e1l\u00f3 Kutat\u00f3hely Budapest, B\u00f3kay J\u00e1nos u. 53\u201354., 1083 Magyarorsz\u00e1g"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00c1gnes","family":"Jermendy","sequence":"additional","affiliation":[{"name":"Semmelweis Egyetem, \u00c1ltal\u00e1nos Orvostudom\u00e1nyi Kar, Neonatol\u00f3giai Tansz\u00e9k, Gyermekgy\u00f3gy\u00e1szati Klinika, MTA Kiv\u00e1l\u00f3 Kutat\u00f3hely Budapest, B\u00f3kay J\u00e1nos u. 53\u201354., 1083 Magyarorsz\u00e1g"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mikl\u00f3s","family":"Szab\u00f3","sequence":"additional","affiliation":[{"name":"Semmelweis Egyetem, \u00c1ltal\u00e1nos Orvostudom\u00e1nyi Kar, Neonatol\u00f3giai Tansz\u00e9k, Gyermekgy\u00f3gy\u00e1szati Klinika, MTA Kiv\u00e1l\u00f3 Kutat\u00f3hely Budapest, B\u00f3kay J\u00e1nos u. 53\u201354., 1083 Magyarorsz\u00e1g"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kata","family":"Kov\u00e1cs","sequence":"additional","affiliation":[{"name":"Semmelweis Egyetem, \u00c1ltal\u00e1nos Orvostudom\u00e1nyi Kar, Neonatol\u00f3giai Tansz\u00e9k, Gyermekgy\u00f3gy\u00e1szati Klinika, MTA Kiv\u00e1l\u00f3 Kutat\u00f3hely Budapest, B\u00f3kay J\u00e1nos u. 53\u201354., 1083 Magyarorsz\u00e1g"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"425","reference":[{"key":"R1","unstructured":"World Health Organization. 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