肺表面活性物质对早产儿呼吸窘迫综合征的疗效及水通道蛋白、TGF-β1、TNF-α的变化研究  

Effects of pulmonary surfactant on respiratory distress syndrome in premature infants and the changes of aquaporin,TGF-β1 and TNF-α

作　　者：赵奇萍 杨慧 Zhao Qiping;Yang Hui(Department of Pediatrics,Shaanxi Nuclear Industry 215 Hospital,Xianyang 712000,China)

机构地区：[1]陕西省核工业二一五医院儿科,咸阳712000

出　　处：《国际呼吸杂志》2022年第10期747-751,共5页International Journal of Respiration

摘　　要：目的研究肺表面活性物质对早产儿呼吸窘迫综合征的疗效及水通道蛋白、血清转化生长因子β1(TGF-β1)、肿瘤坏死因子α(TNF-α)水平的影响。方法本研究为前瞻性队列研究, 选取陕西省核工业二一五医院2017年1月至2019年4月收治的新生儿呼吸窘迫综合征的早产儿62例, 根据单纯随机抽样法分为2组, 氨溴索组31例和肺表面活性物质组31例。2组患者均给予基础治疗, 氨溴索组加用盐酸氨溴索注射液, 肺表面活性物质组在氨溴索组基础上给予肺表面活性物质治疗, 分析2组患者治疗后的临床疗效。结果肺表面活性物质组持续气道正压通气时间、撤机时间、住院时间均显著短于氨溴索组(P值均<0.05)。2组治疗前血气指标水平相当(P>0.05)。治疗后肺表面活性物质组的动脉血氧分压、氧合指数显著高于氨溴索组, 动脉血二氧化碳分压低于氨溴索组(P值均<0.05)。2组治疗前TGF-β1、TNF-α、C反应蛋白、水通道蛋白水平相当(P值均>0.05)。治疗后同氨溴索组相比, 肺表面活性物质组TGF-β1、TNF-α、C反应蛋白、水通道蛋白水平显著更低(P值均<0.05)。氨溴索组和肺表面活性物质组患者住院期间并发症比较, 差异无统计学意义(P>0.05)。结论肺表面活性物质应用于早产儿呼吸窘迫综合征可降低TGF-β1、TNF-α、水通道蛋白的表达, 改善患儿血气分析结果, 缩短疾病的病程。Objective To study the efficacy of pulmonary surfactant(PS)on respiratory distress syndrome in premature infants and the effects on aquaporin,serum transforming growth factor-β1(TGF-β1),and tumor necrosis factor-α(TNF-α)levels.Methods This was a prospective cohort study.A total of 62 premature infants with neonatal respiratory distress syndrome admitted to the No.215 Hospital of Nuclear Industry in Shaanxi Province from January 2017 to April 2019 were selected and divided into two groups using the simple random sampling method.There were 31 cases in the ambroxol group and 31 cases in the PS group.Both groups received basic treatment,the ambroxol group was additionally given ambroxol hydrochloride injection,and the PS group was given PS treatment on the basis of the ambroxol group.The clinical performance of the two groups of patients after treatment was analyzed.Results The duration of continuous positive airway pressure,weaning time,and hospital stay in the PS group were significantly shorter than those in the ambroxol group(all P<0.05).The levels of blood gas indexes in the two groups before treatment were comparable(P>0.05).After treatment,the arterial blood oxygen partial pressure and oxygenation index in PS group were significantly higher than those in ambroxol group,and the arterial blood carbon dioxide partial pressure was lower than that in ambroxol group(all P<0.05).Before treatment,the levels of TGF-β1,TNF-α,C-reactive protein and aquaporin in the two groups were comparable(all P>0.05).Compared with the ambroxol group after treatment,the levels of TGF-β1,TNF-α,C-reactive protein and aquaporin in the PS group were significantly lower(all P<0.05).There was no significant difference in hospital complications between the ambroxol group and the PS group(P>0.05).Conclusions The application of PS to premature infants with respiratory distress syndrome can reduce the expression of TGF-β1,TNF-αand aquaporin,improve the results of blood gas analysis and shorten the course of the disease.

关 键 词：呼吸窘迫综合征 水孔蛋白质类 肿瘤坏死因子α 肺表面活性物质 早产儿 血清转化生长因子Β1 

分 类 号：R722.6[医药卫生—儿科]