布地奈德气管内滴入对呼吸窘迫综合征早产儿肺泡灌洗液细胞因子水平的影响  

Effects of budesonide intratracheal instillation on the cytokines in bronchoalveolar lavage fluid in premature infants with respiratory distress syndrome

作　　者：储晓彬[1] 晏路标[2] 韩树萍[2] 郭锡熔[2] 

机构地区：[1]南通市第一人民医院儿科,江苏省226001 [2]南京医科大学附属南京妇幼保健院新生儿科

出　　处：《江苏医药》2012年第23期2831-2834,共4页Jiangsu Medical Journal

基　　金：南通市科技发展基金资助(S2010060);第二届双鹤珂立苏科研基金资助项目(cjp2011008);南京医科大学科技发展基金资助项目(2010NJMU025)

摘　　要：目的探讨布地奈德(BUD)联合肺表面活性物质(PS)气管内滴入对机械通气的极低出生体质量儿肺部炎症因子的影响。方法早产儿60例,胎龄<34周,出生体重<1500g,生后4h内发生新生儿呼吸窘迫综合征(RDS),实施机械通气。随机分为两组,每组30例。PS+BUD组用PS 70mg/kg+BUD 0.25mg/kg;PS组单用PS 70mg/kg;生后30-60min内气管内滴入。第1、3、5、7、10天测定肺泡灌洗液IL-1β、TNF-α、IL-6和IL-10。结果用药第5、7、10天,PS+BUD组的IL-1β、IL-6和TNF-α明显低于PS组(P<0.05),IL-10明显高于PS组(P<0.05)。结论联合应用BUD和PS可使机械通气RDS患儿肺部促炎因子表达下调,而抑炎因子上调。Objective To investigate the effects of budesonide（Bud） intratracheal instillation on the cytokines in bronchoalveolar lavage fluid（BALF） in infants with respiratory distress syndrome（RDS）.Methods Sixty premature infants with gestational age 34 weeks and birth weight 1500 g sufferred from RDS within 4 hours after birth,who underwent mechanical ventilation and were randomly assigned into two groups with 30 cases each.The infants in group PS＋BUD were given pulmonary surfactant（PS） 70 mg/kg＋BUD 0.25 mg/kg and those in group PS 70 mg/kg alone.The drug was intratracheally dropped within 30 to 60 minutes after birth.The interleukin（IL）1β（IL-1β）,IL-6,IL-10 and tumor necrosis factor alpha（TNF-α） in BALF were detected on the 1st,3rd,5th,7th and 10th day after birth.Results Compared to group PS,the cotents of IL-1β,IL-6 and TNF-α were lower,but those of IL-10 were higher,in group PS＋BUD on the 5th,7th and 10th day after birth（P0.05）.Conclusion Combined use of Bud and PS can make the inflammation-suppressive cytokines upregulated and the proinflammatory cytokines downregulated in the lungs of premature infants with RDS.

关 键 词：早产儿 呼吸窘迫综合征 布地奈德 肺表面活性物质 机械通气 炎症因子 

分 类 号：R722[医药卫生—儿科]