呼吸机依赖患者痰液中SP-A与动脉血氧合指数变化的研究  

The changes of pulmonary surfactant associated protein of sputum and oxygenation index in dysfunctional ventilatory weaning response patients

作　　者：邓扬嘉[1] 吴倩[1] 魏裕红[1] 杜磊[1] 付莲[1] 

机构地区：[1]重庆市中医院重症医学科,400021

出　　处：《重庆医学》2014年第20期2572-2573,2576,共3页Chongqing medicine

基　　金：重庆市卫生局科研项目(2010-2-240)

摘　　要：目的测定呼吸机依赖患者痰液中肺表面活性物质相关蛋白-A(SP-A)的表达,研究SP-A与氧合指数及动脉血氧分压水平的变化。方法将机械通气患者分为呼吸机依赖组(A组)和顺利脱机组(B组),收集患者上呼吸机不同阶段上机当天及上机后2、7d的痰液标本,应用ELISA检测两组患者痰液上清液中SP-A水平和相应时段的动脉氧分压。结果上机当天A组SP-A水平、氧合指数、动脉氧分压低于B组(P<0.05);A组上机2d痰液中SP-A水平低于上机当天,上机7d低于上机2d,差异有统计学意义(P<0.05);A组上机2d氧合指数及氧分压高于上机当天(P<0.05),上机后7d氧合指数、氧分压与上机后2d比较差异无统计学意义(P>0.05)。结论通过检测痰液中SP-A水平可早期判断呼吸机依赖或呼吸机相关性肺损伤的发生,可提供新的治疗途径及思路。Objective To explore the expression of SP-A in surface active substance of sputum pulmonary of dysfunctional venti-latory weaning response patients and to study changes of expression of SP-A and oxygenation index ,arterial partial pressure of oxy-gen .Methods The mechanical ventilatory patients were divide into dysfunctional ventilatory weaning response group （group A） and easily weaning group（group B） ,then collected sputum from ventilators at different times ：on the first day ,two and seven days after using ventilators .Used ELISA to test level of SP-A and oxygenation index ,arterial partial pressure of oxygen in sputum of group A and group B .Results For group A ,SP-A content oxygenation index and arterial partial pressure of oxygen were significantly less than those for group B（P〈0 .05）;after two days ,for group A ,SP-A content in sputum was significantly less than that on the first day ,and SP-A content in sputum was significantly less than that on the second day （P〈0 .05）;two days later ,oxygenation index and arterial partial pressure of oxygen were significantly lmore than those on the first day （P〈0 .05） and there was no statistical difference in oxygenation index and arterial partial pressure of oxygen between the seventh day and the second day （P〉0 .05） .Con-clusion Dysfunctional ventilatory weaning response and lung injury related to ventilator can be diagnosed early through the test of SP-A content in sputum ,which provides a brand-new way and method of treatment in dysfunctional ventilatory weaning response and lung injury related to ventilator .

关 键 词：肺表面活性物质相关蛋白A 血气分析 呼吸机依赖 

分 类 号：R563.8[医药卫生—呼吸系统]