猪肺磷脂注射液不同给药时机对新生儿呼吸窘迫综合征患儿气道炎症、肺损伤的影响  

Effects of Different Administration Timing of Pulmonary Surfactant on Airway Inflammation and Pulmonary Injury in Children with Neonatal Respiratory Distress Syndrome

作　　者：郝京涛 赵进 汪利超 HAO Jingtao;ZHAO Jin;WANG Lichao(Dept.of Neonatology,Anhui Ma’anshan Maternal and Child Health Hospital,Anhui Ma’anshan 243000,China)

机构地区：[1]安徽马鞍山市妇幼保健院新生儿科,安徽马鞍山243000

出　　处：《中国医院用药评价与分析》2023年第2期187-190,共4页Evaluation and Analysis of Drug-use in Hospitals of China

基　　金：安徽省卫生厅医药科研计划项目(No.12925KJ2017B22)。

摘　　要：目的:探讨猪肺磷脂注射液不同给药时机对新生儿呼吸窘迫综合征(NRDS)患儿气道炎症、肺损伤的影响。方法:选取2019年10月至2021年10月该院收治的NRDS患儿63例,采用随机数字表法分为早期组、中期组和晚期组,各21例。三组患儿均采取猪肺磷脂注射液治疗,早期组于出生<4 h给药,中期组于出生4~8 h给药,晚期组于出生>8 h给药。统计三组患儿的康复进程、不良事件发生率,治疗前后血气分析指标[动脉血二氧化碳分压(PaCO_(2))、动脉血氧分压(PaO_(2))和吸入氧浓度(FiO_(2))]、肺损伤指标[肺表面活性蛋白A(SP-A)、Toll样受体4(TLR-4)和Toll样受体2(TLR-2)]、气道炎症指标[核因子κB(NF-κB)、c-Jun氨基末端蛋白激酶(JNK)]水平。结果:(1)治疗后24 h,早期组患儿的PaCO_(2)、FiO_(2)、SP-A、TLR-4、TLR-2、NF-κB和JNK水平低于中期组、晚期组,PaO_(2)高于中期组、晚期组,差异均有统计学意义(P<0.05);治疗后24 h,中期组和晚期组患儿上述指标水平比较,差异均无统计学意义(P>0.05)。(2)早期组患儿的氧疗时间、机械通气时间短于中期组、晚期组,差异均有统计学意义(P<0.05);中期组与晚期组患儿氧疗时间、机械通气时间比较,差异均无统计学意义(P>0.05)。三组患儿住院时间比较,差异无统计学意义(P>0.05)。(3)三组患儿不良事件发生率及病死率比较,差异无统计学意义(P>0.05)。结论:猪肺磷脂注射液不同给药时机在NRDS患儿中效果差异明显,其中出生4 h内给药可显著改善患儿血气指标,减轻气道炎症,延缓肺损伤。OBJECTIVE:To probe into the effects of different administration timing of pulmonary surfactant on airway inflammation and pulmonary injury in children with neonatal respiratory distress syndrome(NRDS).METHODS:A total of 63 children with NRDS admitted into the hospital from Oct.2019 to Oct.2021 were extracted to be divided into the early-stage group,intermediate-stage group and late-stage group via the random number table method,with 21 cases in each group.All three groups were treated with pulmonary surfactant injection.The early-stage group was given pulmonary surfactant injection within 4 h after birth,the intermediate-stage group was given pulmonary surfactant from 4 to 8 h after birth,and the late-stage group was given pulmonary surfactant more than 8 h after birth.Rehabilitation process,incidence of adverse events and blood gas analysis indicators[arterial partial pressure of oxygen(PaCO_(2)),arterial partial pressure of oxygen(PaO_(2)),inspired oxygen concentration(FiO_(2)],and pulmonary injury indicators[pulmonary surfactant relate-staged protein A(SP-A),Toll-like receptor 4(TLR-4),Toll-like receptor 2(TLR-2)],airway inflammation indicators[nuclear factor-kB(NF-κB),c-Jun N-terminal protein kinase(JNK)]before and after treatment were counted among three groups.RESULTS:(1)After treatment of 24 h,the levels of PaCO_(2),FiO_(2),SP-A,TLR-4,TLR-2,NF-κB and JNK in the early-stage group were lower than those in the intermediate-stage group and late-stage group,and PaO_(2)was higher than that in the intermediate-stage group and late-stage group(P<0.05).After treatment of 24 h,there was no significant difference in above indicators between the intermediate-stage group and late-stage group(P>0.05).(2)The duration of oxygen therapy and mechanical ventilation in the early-stage group were shorter than those in the intermediate-stage group and late-stage group,the differences were statistically significant(P<0.05).There were no significant differences in the duration of oxygen therapy and mechanical ventilation betwee

关 键 词：新生儿呼吸窘迫综合征 猪肺磷脂注射液 气道炎症 肺损伤 康复进程 

分 类 号：R985[医药卫生—药品]