目的 探讨早产儿晚发性循环衰竭（late-onset circulatory collapse, LCC）的早期临床表现、随机皮质醇水平及诊治方法。 方法 收集南京医科大学附属苏州医院2023年10—12月出现LCC的早产儿病例，回顾性分析母亲围产期因素及患儿早期临床症状、体征、随机血清皮质醇水平、治疗和结局。 结果 纳入7例LCC早产儿，胎龄25⁺²~29周，出生体重800~1 150 g。患儿生后3周出现异常体重增长［增长速率21~28.5 g/（kg·d）］、全身性水肿、血钠偏低（129.5~135.2 mmol/L）、随机血清皮质醇浓度下降（13.6~44.6 nmol/L），予氢化可的松治疗1~2周后，水肿较前消退，血钠升高。 结论 临床情况相对稳定的早产儿LCC早期表现为异常体重增长、全身性水肿、反复低钠血症、随机血清皮质醇浓度下降，给予氢化可的松治疗可有效改善症状。

Objective To explore the early clinical manifestations, random cortisol levels, and management of late-onset circulatory collapse (LCC) in preterm infants. Methods Preterm infants with LCC from October to December 2023 at the Affiliated Suzhou Hospital of Nanjing Medical University were included. Maternal perinatal factors and infants' early clinical symptoms, signs, random serum cortisol levels, treatment, and outcomes were retrospectively analyzed. Results Seven preterm infants with LCC were included, with gestational ages of 25 weeks + 2 days to 29 weeks and birth weights of 800-1 150 g. At 3 weeks of age, abnormal weight gain [gain rate: 21-28.5 g/(kg·d)], generalized edema, low serum sodium (129.5-135.2 mmol/L), and decreased random serum cortisol concentrations (13.6-44.6 nmol/L) were observed. After 1-2 weeks of hydrocortisone treatment, edema subsided and serum sodium increased. Conclusions In clinically stable preterm infants, early manifestations of LCC include abnormal weight gain, generalized edema, recurrent hyponatremia, and decreased random serum cortisol concentrations. Hydrocortisone treatment effectively improves symptoms.