肺表面活性剂治疗新生儿呼吸窘迫综合征疗效的影响因素  

Factors influencing the efficacy of surfactant replacement therapy for neonatal respiratory distress syndrome

作　　者：李杰[1] 樊寻梅[2] 宋国维[1] 李克华[2] 郭在晨[3] 叶鸿瑁[4] 崔玉涛[2] 甘小庄[1] 王颖[3] 朴梅花[4] 

机构地区：[1]首都儿科研究所,北京100020 [2]北京儿童医院,北京100045 [3]北京医科大学第一医院,北京100034 [4]北京医科大学第三医院,北京100083

出　　处：《小儿急救医学》2003年第1期12-14,共3页Pediatric Emergency Medicine

摘　　要：目的　 观察肺表面活性剂 (PS)对新生儿呼吸窘迫综合征 (NRDS)疗效的影响因素。 方法 　采用回顾性病例对比分析方法 ,对 42例经气管注入接受PS治疗的NRDS患儿 ,按PS治疗前 5min血气分析结果 ,分为 pH <7 2 5 (A)和 pH≥ 7 2 5 (B)组。观察两组PS治疗前后a/APO2 的变化。再将每一组分别按孕周和体重大小分为孕周 <3 1周和孕周≥ 3 1周组、体重≥1 75kg和体重≥ 1 75kg组。观察不同孕周和不同体重患儿接受PS治疗前后a/APO2 的变化。 结果 　A、B两组患儿PS治疗前a/APO2 均无显著差异 ,PS治疗后 0 5、1、6、12h时 ,B组的a/APO2 均明显高于A组 ,差异有显著意义 (P均 <0 0 5 )。A组内孕周≥ 3 1周的患儿 ,PS治疗前a/APO2 明显低于孕周 <3 1周组 ,差异有显著意义 (P <0 0 5 ) ,PS治疗后各个观察时间 ,两组的a/APO2 均无显著差异。A组内体重≥ 1 75kg的患儿 ,PS治疗前a/APO2 明显低于体重 <1 75kg组 ,差异有显著意义 (P <0 0 5 ) ,PS治疗后各个观察时间 ,两组a/APO2 无显著差异。PS治疗前和治疗后 ,B组内不同孕周和不同体重患儿的a/APO2 均无显著差异。 结论Objective To analyze factors influencing the efficacy of surfactant replacement therapy for neonatal respiratory distress syndrome.Methods Forty two NRDS infants who had been treated with Curosurf were retrospectively divided into group A (pH<7 25) and B (pH≥7\^25) according to the blood gas at 5 min before receiving Curosurf.Each group was subdivided into subgroup with gestation age <31 weeks or ≥31 weeks,and subgroup with body weight <1\^75kg or ≥1\^75kg,respectively.The change of a/APO\-2 after the Curosurf therapy was observed.Results Before the Curosurf therapy,there was no difference in the level of a/APO\-2 between group A and group B.At 0\^5,1,6,12 hours after the administration of Curosurf,the level of a/APO\-2 in group B was significantly higher than that in group A ( P <0\^05) In group A,the level of a/APO\-2 in the infants with gestation age ≥31 weeks was significantly lower than that with gestation age <31 weeks ( P <0 05) before treatment.After receiving Curosurf,no difference in the level of a/APO\-2 was observed between the two subgroups at each time point.In group A,the level of a/APO\-2 in the infants with body weight ≥1\^75kg was significantly lower than that with the body weight <1\^75kg ( P <0\^05) before treatment.After receiving Curosurf,there was no difference between the two groups at different time points.Conclusion Serous acidosis could decrease the efficacy of surfactant therapy for neonatal respiratory distress syndrome.

关 键 词：肺表面活性剂 治疗 新生儿 呼吸窘迫综合征 疗效 

分 类 号：R722.1[医药卫生—儿科]