新生儿肺部疾病支气管肺泡灌洗液肺表面活性蛋白A的检测及意义  

Concentrations of bronchoalveolar lavage pulmonary surfactant protein A and its significance in newborn infants with lung disease.

作　　者：吕回[1] 黄晓虹[1] 赵宁[1] 陈晓文[1] 陆玲[1] 周伟[1] 赖剑蒲[1] 顾晓琼[1] 赵小朋[2] 

机构地区：[1]广州市儿童医院,510120 [2]广州市妇婴医院,510120

出　　处：《中国实用儿科杂志》2005年第7期418-420,共3页Chinese Journal of Practical Pediatrics

摘　　要：目的探讨新生儿常见肺部疾病支气管肺泡灌洗液肺表面活性蛋白A(BALSPA)水平及其与临床的关系。方法收集2000年1月至2003年2月在广州市儿童医院新生儿重症监护室住院的需行机械通气治疗的新生儿重症肺炎、胎粪吸入综合征(MAS)、急性呼吸窘迫综合征(ARDS)以及新生儿呼吸窘迫综合征(RDS)患儿共57例。测定其BALSPA水平,监测血气、PaO2/FiO2水平。结果重症肺炎组与MAS组患儿BALSPA水平无明显差异,但MAS组患儿PaO2、PaCO2及PaO2/FiO2水平较重症肺炎组明显降低(P值<0.01,<0.05,<0.05);ARDS及RDS组患儿BALSPA水平均较上述两组低(P值均<0.001),而RDS组患儿BALSPA水平较ARDS组低(P<0.001),但ARDS组患儿PaO2水平较RDS组患儿低(P<0.05)。PS治疗组患儿的病死率较非PS治疗组明显降低(P=0.049),其PaO2/FiO2与BALSPA水平密切相关(r=0.741,P=0.000)。结论与重症肺炎患儿比较胎粪吸入综合征患儿BALSPA水平无明显降低;ARDS及RDS患儿BALSPA水平明显降低;BALSPA水平能反映新生儿肺损伤的严重程度,对于新生儿肺部疾病预后的判断有一定意义。Objective To investigate the bronchoalveolar lavage (BAL) SP-A concentrations from newborn infants with lung disease,and to study the relationship between BAL SP-A and clinical outcome.Methods 57 cases of newborn infants with lung disease were admitted in our NICU between Jan.2000 and Feb.2003.BAL SP-A concentrations,PO_2 value,PCO_2 value,and PaO_2/FiO_2 ratio were measured.Results BAL SP-A concentrations did not differ between severe pneumonia group and MAS group,but the value of PaO_2、PaCO_2 and PaO_2/FiO_2 ratio in MAS group were significantly lower than that in severe pneumonia group (p respectively<0.001,<0.05,<0.05).BAL SP-A concentrations in RDS and ARDS groups were significantly lower than that in aforesaid groups ( all P <0.05).BAL SP-A concentrations in RDS group were significantly lower than that in ARDS group,but PaO_2 value in ARDS group was lower significantly than that in RDS group( P <0.05).The mortality of infants treated with PS was significantly lower than that of infants treated without PS ( P =0.049).PaO_2/FiO_2 ratio for the cohort was related to their BAL SP-A concentrations ( r =0.741, P =0.000).Conclusion Surfactant protein A content in MAS is not different from that of severe pneumonia.BAL SP-A concentrations of neonates with ARDS or RDS decrease significantly.BAL SP-A concentrations can evaluate the severity of lung injury and the prognosis of neonatal lung disease.

关 键 词：婴儿 新生肺部疾病 支气管肺泡灌洗肺表面活性蛋白A 

分 类 号：R72[医药卫生—儿科]