胎粪吸入综合征及并发持续肺动脉高压的肺机制研究  

Lung function changes of meconium aspiration syndrome with pulmonary hypertension in neonates

作　　者：吴红敏[1] 李娟[1] 薜辛东 魏克伦[1] 黄薇薇[1] 

机构地区：[1]中国医科大学第二临床学院儿科,沈阳110003

出　　处：《中华儿科杂志》1999年第11期677-679,共3页Chinese Journal of Pediatrics

摘　　要：目的　探讨胎粪吸入综合征（ＭＡＳ） 及并发持续肺动脉高压（ＰＰＨＮ） 患儿的肺功能变化。方法　应用美国Ｂｉｃｏｒｅ 公司的ＣＰ１００ 新生儿肺功能监护仪检测２０ 例ＭＡＳ患儿的肺功能。　结果ＭＡＳ患儿呼吸频率（ＲＲ） 为（８３ ±１５） 次／ｍｉｎ，气道阻力（ＡＲ） 为（１０８ ±４６）ｃｍＨ２Ｏ／（Ｌ·ｓ），比对照组的（４５±６－０） 次／ｍｉｎ、（３８ ±１７） ｃｍＨ２Ｏ／（Ｌ·ｓ） 明显增高（ｔ＝ ２－３０，２－５１ ，Ｐ＜ ０－０５） ；潮气量（ＴＶ） 为（２－２ ±０－６）ｍｌ／ｋｇ，动态肺顺应性（Ｃｄｙｎ） 为（０－４４ ±０－２８） ｍｌ／（ｃｍＨ２Ｏ·ｋｇ） ，比对照组的（４－６１ ±１－４２） ｍｌ／ｋｇ、（１－４±０－６）ｍｌ／（ｃｍＨ２Ｏ·ｋｇ） 明显降低（ｔ＝２－７１、２－８１，Ｐ＜ ０－０５）。并发ＰＰＨＮ 患儿的ＴＶ（１－８ ±０－３） ｍｌ／ｋｇ 和Ｃｄｙｎ （０－２６ ±０－０６）ｍｌ／（ｃｍＨ２Ｏ·ｋｇ） ，比无ＰＰＨＮ 患儿的（２－５４ ±０－７３）ｍｌ／ｋｇ 和（０－６０ ±０－３５）ｍｌ／（ｃｍＨ２Ｏ·ｋｇ） 明显降低（ｔ＝ ２－８１，２－８３，Ｐ＜ ０－０５） ，且肺动脉压力高低与ＴＶ、Ｃｄｙｎ 呈明显负?Objective To study the lung function in neonates with meconium aspiration syndrome (MAS) Methods The lung functions of 20 neonates with MAS was tested by Biocore CP 100 neonatal pulmonary function monitor Results The respiratory rate (RR) and airway resistance (AR) in neonates with MAS [(83±15) bpm and (108±46) cmH 2O/(L·s)] were significantly higher than thoses in control [(45±6 0) bpm, (38± 17) cmH 2O/(L·s)] ( P< 0 05), but the tidal volume (TV) and dynamic lung compliance (Cdyn) (2 2± 0 6) ml/kg and (0 44±0 28) ml/(cmH 2O·kg) were significantly lower than those in control [(4 6±1 4) ml/kg and (0 44±0 28) ml/(cmH 2O·kg) (1 4±0 6) ml/(cmH 2O·kg)] ( P< 0 05) In neonates with MAS, the values of TV and Cdyn in patients with persistant pulmonary hypertension (PPHN) were significantly lower than those in patients without PPHN (1 8±0 3) ml/kg and (2 54±0 73) ml/kg, vs (0 26±0 06) ml/(cmH 2O·kg) and (0 6±0 31) ml/(cm·H 2O·kg) ( P< 0 05) The level of pulmonary artery pressure was negatively correlated with TV and Cdyn respectively ( r =-0 687, -0 712) Conclusion The lung function in neonates with MAS changed significantly, TV and Cdyn in neonates of MAS with PPHN changed more significantly The results suggest that TV and Cdyn might be useful for determination of MAS with PPHN and to evaluation of the severity of MAS with PPHN

关 键 词：肺性高血压 肺顺应性 新生儿 

分 类 号：R725.432[医药卫生—儿科] R722[医药卫生—临床医学]