肺表面活性物质联合机械通气对新生儿呼吸窘迫综合征的氧合功能、血清转化生长因子及骨形态发生蛋白7表达水平的影响  

Effects of Pulmonary Surfactant Combined with Mechanical Ventilation on Oxygenation Function,Serum Trans⁃forming Growth Factor and Expression Levels of Bone Morphogenetic Protein 7 in Neonatal Respiratory Distress Syn⁃drome

作　　者：毛庆花 李朝晖[1] 郭瑞[1] 曹修丽[1] MAO Qing-hua;LI Zhao-hui;GUO Rui(Department of Pediatrics,Jining First People’s Hospital,Jining,Shandong,272000,China)

机构地区：[1]济宁市第一人民医院儿科,山东济宁272000

出　　处：《黑龙江医学》2022年第14期1678-1680,共3页Heilongjiang Medical Journal

摘　　要：目的:探讨早期应用肺泡表面活性物质(PS),对新生儿呼吸窘迫综合征(NRDS)患儿的氧合功能、转化生长因子β1(TGF-β1)及骨形态发生蛋白7(BMP-7)的影响,为NRDS的早期防治提供帮助。方法:收集2018年6月—2020年9月济宁市第一人民医院50例需要进行机械通气(CMV)治疗的NRDS患儿,分为两组。25例出生后12 h内给予肺泡表面活性物质作为PS组。25例未使用PS的患儿作为CMV组,分别于出生后0 d、1 d、3 d、7 d采用酶联免疫吸附法(ELASA)测定两组患儿血清中TGF-β1及BMP-7的表达情况并监测氧合功能指标。结果:(1)PS组与CMV组患儿血清TGF-β1与BMP-7含量在出生1 d后均出现升高趋势,出生后7 d则较前有所下降。出生后3 d、7 d TGF-β1含量及出生后7 d BMP-7表达水平CMV组明显高于PS组,差异有统计学意义(P<0.05)。经治疗后的6 h、12 h、24 h、48 h氧指数(OI)、呼吸指数(RI)值比较,PS组低于CMV组,差异有统计学意义(P<0.05)。(2)PS组的机械通气时间(81±25)h短于CMV组的(102±24)h,PS组用氧时间(99±37)h短于CMV组的(122±28)h,差异有统计学意义(P<0.05)。PS组与CMV组治疗有效率分别为96%、84%,PS组治疗效果显著高于CMV组,差异有统计学意义(P<0.05)。结论:早期应用PS联合机械通气可明显改善肺顺应性,提高氧合功能,抑制炎症反应,有效治疗NRDS,检测血清TGF-β1及BMP-7水平的变化情况,对NRDS的治疗和预后评估具有重要意义。Objective:To investigate the effects of early application of alveolar surfactant(PS)on oxygenation function,trans⁃forming growth factorβ1(TGF-β1)and bone morphogenetic protein 7(BMP-7)in children with neonatal respiratory distress syn⁃drome(NRDS),to provide help for the early prevention and treatment of NRDS.Methods:A total of 50 children with NRDS who needed mechanical ventilation(CMV)in the hospital from June 2018 to September 2020 were collected and divided into two groups.25 infants who were given alveolar surfactant within 12 h after birth were assigned to the PS group,and 25 infants who did not receive PS were assigned to the CMV group.The expressions of TGF-β1 and BMP-7 in serum of the two groups of children were measured by enzyme-linked immunosorbent assay(ELASA)on 0 d,1 d,3 d,and 7 d after birth,and oxygenation function in⁃dexes were monitored.Results:(1)The levels of serum TGF-β1 and BMP-7 in PS group and CMV group showed an increasing trend after 1 d after birth,and decreased at 7 d after birth.The content of TGF-β1 and the expression level of BMP-7 on the 3rd and 7th d after birth in the CMV group were significantly higher than those in the PS group,and the differences were statistically significant(P<0.05).The oxygen index(OI)and respiratory index(RRI)values of the PS group at 6 h,12 h,24 h,and 48 h after treatment were lower than those of the CMV group,and the differences were statistically significant(P<0.05).(2)The mechanical ventilation time of the PS group was(81±25)h,which was shorter than(102±24)h of the CMV group,and the oxygenation time of the PS group was(99±37)h,which was shorter than(122±28)h of the CMV group,the difference was statistically significant(P<0.05).Conclusion:Early application of PS combined with mechanical ventilation can significantly improve lung compliance,im⁃prove oxygenation function,inhibit inflammatory response,and effectively treat NRDS.Detecting the changes of serum TGF-β1 and BMP-7 levels is of great significance for the treatment and prognosis e

关 键 词：新生儿 呼吸窘迫综合征 肺泡表面活性物质 氧合功能 

分 类 号：R272.1[医药卫生—中医儿科学]