32例早产儿咽吸出物检查预测胎肺成熟度

本文通过对32例早产儿分娩时羊水、咽吸出物、死亡新生儿大气管冲洗物等做系列磷脂酰甘油(PG)的检查,预测胎肺成熟度,并结合临床诊断、X 线检查、死亡病例的肺组织病理检查来验证其准确性.结果表明:大气管PG 的准确性100%,咽吸出物96.88%,羊水87.5%,均无假阳性.提示:早产儿孕周与胎肺成熟度无明显相关性.早产儿出生时,及时留取羊水,咽吸出物测PG 以了解肺成熟度,对于指导临床诊断与治疗有重要意义.     

乐舒凡预防早产儿肺透明膜病的临床研究

目的：评价乐舒凡预防新生儿肺透明膜病的临床疗效。方法将73例胎龄29W～35W、体重1200g～2250g的早产儿随机分为两组,预防组生后2小时内口服或胃管注入乐舒凡,对照组不用乐舒凡,两组患儿均给予相同的综合治疗,比较两组患儿发生肺透明膜病的机率、及发生肺透明膜病后需要转院治疗的例数。结果预防组肺透明膜病发生率及发生肺透明膜病后需要转院治疗的例数均比对照组少,二者比较有统计学意义（P〈0.05）。结论在基层医院早产儿生后早期应用乐舒凡,对减少NRDS的发生及减轻NRDS的严重程度是有效的。     

羊水板层体计数预测胎肺成熟度

目的　探讨羊水板层体计数 (L am ellar body count,L BC)预测胎肺成熟度的价值。　方法　采用库尔特 Micro Diff II全自动血细胞分析仪对 41例正常足月妊娠剖宫产时的羊水标本进行L BC的测定 ,并对同一标本采用薄板层析法测定了卵磷脂 /鞘磷脂比值 (L ecithin- sphingomyelin,L / S比值 )。　结果 (1)正常足月妊娠时羊水 L BC为 (86± 43)× 10 3 (范围 72 .5× 10 3 ～ 99.4× 10 3 )。 (2 )羊水 L BC与 L / S比值之间存在正相关 ,r=0 .6 6 ,P=0 .0 0 1。　结论　羊水 L BC是一种快速、准确地判断肺成熟度的方法     

受污染羊水磷脂酰甘油等五项指标预测胎儿成熟度的评价

受污染羊水磷脂酰甘油等五项指标预测胎儿成熟度的评价赵右更，苏绮凤，方晓霞，费新娣，邵延龄多项产前预测胎儿成熟度指标，易受污染羊水的影响￣［１］。本研究对受污染羊水影响较小的磷脂酰甘油（ＰＧ）￣［２］及掸拍快速法（Ｔａｐ）￣［３，４］、卵磷脂（Ｌ）／鞘...     

早产儿肺透明膜病的临床X线分析

目的：分析早产儿肺透明膜病的x线特征及早期x线表现,提高对本病的认识和早期诊断、旱治疗。方法：回顾2010至2（112年间在我院生产的早产儿肺透明膜病56例的临床资料不同时龄x线仰卧位吸气胸片。结果：轻度（I、Ⅱ级）47例,其中12例中下野两肺纹理边缘模糊,表现小网格样及小颗粒状增高影,肺野透亮度减低,32例有心影后支气管充气征中度（3级）7例,表现两肺野呈细磨玻璃样和粗磨玻璃样改变,均有明显支气管充气征。心缘较模糊和毛糙;重度（Ⅳ级）双肺野透明度极低（白肺）,未见支气管充气征,心缘及膈面消失,肋膈角可见。本组病例中一例伴有间质性肺水肿,一例纵膈积气,见胸腺抬高征。结论：早产儿肺透明膜病x线仰卧位吸气胸片是简捷、实用的检查方法。两下肺纹理边缘模糊。内中带小网格及小颗粒状增高影、透亮度减低、心影后支气管气征是HMD的早期x线表现。     

不同剂量地塞米松对早产胎鼠肺成熟度及生长发育的影响

目的　探讨不同剂量的地塞米松促进胎鼠肺成熟的效果及其对孕鼠和仔鼠的影响。方法　 6 0只定时受孕的Wistar大鼠 ,随机分为安慰剂组、小剂量组、中剂量组及大剂量组 4组 ,每组 15只。于妊娠第 15、16天分别给予如下处理 :安慰剂组孕鼠皮下注射生理盐水 0 8ml、小剂量组孕鼠皮下注射地塞米松 0 2mg、中剂量组孕鼠皮下注射地塞米松 0 4mg、大剂量组孕鼠皮下注射地塞米松0 8mg ,药物均分 4次皮下注射。妊娠 17d时 ,每组随机选择 10只孕鼠行剖宫术取胎 ,其余 5只孕鼠等待自然分娩。观察各组早产仔鼠的呼吸能力、肺组织学评分及羊水板层小体 (LB)记数 ,比较不同剂量的地塞米松对胎肺成熟的影响 ;观察孕鼠的围产期情况及仔鼠体重、肝脏和肾上腺结构等 ,比较不同剂量地塞米松对母、胎的副作用。结果　小剂量组、中剂量组及大剂量组仔鼠的 3种肺成熟度指标显著高于安慰剂组 (P <0 0 5 )。安慰剂组、小剂量组、中剂量组及大剂量组仔鼠的呼吸评分依次为1 4± 0 5、3 6± 0 7、4 2± 0 5及 4 5± 0 5 ;肺组织学评分依次为 1 4± 0 6、3 9± 0 9、4 2± 0 7及 4 4±0 6 ;羊水LB记数依次为 (8 6± 3 0 )× 10 9 ml、(30 2± 4 2 )× 10 9 ml、(33 0± 3 4 )× 10 9 ml及 (35 8±2 7)× 10 9 ml     

应用羊水板层小体计数预测胎肺成熟度

羊水中板层小体(LB)富含卵磷脂，是肺表面活化物质合成与储存的场所。LB由肺泡Ⅱ型细胞排出后可附于胎肺泡腔表面，并随肺液流入羊水中，随着胎肺成熟，羊水中LB数量增多，据此可估计胎肺成熟度、预测呼吸窘迫综合征(RDS)发生率。该法在预测胎肺成熟度方面优于传统磷酯分析并有较高的阴性预测值。LB计数快速、省力、简单、廉价、客观，在有电子细胞计数仪的实验室均能开展，有很高的临床应用价值。     

应用羊水板层小体计数预测胎肺成熟度

羊水中板层小体(LB)富含卵磷脂,是肺表面活化物质合成与储存的场所.LB由肺泡Ⅱ型细胞排出后可附于胎肺泡腔表面,并随肺液流人羊水中,随着胎肺成熟,羊水中LB数量增多,据此可估计胎肺成熟度、预测呼吸窘迫综合征(RDS)发生率.该法在预测胎肺成熟度方面优于传统磷酯分析并有较高的阴性预测值.LB计数快速、省力、简单、廉价、客观,在有电子细胞计数仪的实验室均能开展,有很高的临床应用价值.     

盐酸氨溴索与激素联合使用预防新生儿肺透明膜病

目的研究在应用肾上腺糖皮质激素的基础上加用盐酸氨溴索(沭舒坦)预防新生儿肺透明膜病的效果.方法将1999年1月至2001年6月我院出生的早产儿分为3组实验1组激素加产前用沐舒坦组;实验2组激素加产前或产后用沭舒坦组;对照组;单用激素组.比较3组新生儿肺透明膜病(HMD)的发生率.结果实验1组、2组HMD的发病率均为0%,对照组为16.67%,高于两组实验组,统计学差异有显著意义(P＜0.05).结论①产前在使用激素的基础上加用沭舒坦可预防HMD的发生,疗效优于单用激素预防.②从总体而言,在母亲产前使用激素的基础上,不论是采用产前孕母加用沐舒坦,还是产后新生儿用沐舒坦,均可有效降低HMD的发生率,疗效优于单用激素预防.     

应用羊水中板层小体计数预测胎肺成熟度

为探讨应用羊水中板层小体（ｌａｍｅｌａｒｂｏｄｙ,ＬＢ）计数预测胎肺成熟度的临床应用价值,我们通过羊水中ＬＢ计数,对新生儿呼吸窘迫综合征（ＲＤＳ）取得了较好的预测效果。现报道如下。一、资料与方法１临床资料：选取１９９７年１２月至１９９８年６月在我院...     

羊水板层小体计数预测胎肺成熟度的临床应用

目的:探讨羊水板层小体(LB)计数在预测胎肺成熟度中的意义.方法:检测106例孕妇的122份LB数值,其中16例取经过地塞米松促胎肺成熟前后两次羊水测定,并随访新生儿结局.结果:LB数值随孕周增加而增长;经地塞米松促胎肺成熟治疗后,板层小体数值测定有明显增长;不同LB数值的新生儿呼吸窘迫综合征(RDS)发生率差异有高度统计学意义(P<0.01).结论:LB计数可作为胎儿肺成熟度的指标,操作简单、快速,结果客观、可靠,可作为首选的胎肺成熟度快速筛选检查方法.     

肺透明膜病早产儿尸检肺组织肺表面活性蛋白-C及Ki67的表达

目的 探讨肺透明膜病(HMD)早产儿经机械通气/高氧或肺表面活性物质(PS)替代治疗后其尸检肺组织肺表面活性蛋白-C(SP-C)及增殖抗原Ki67表达情况,分析临床治疗与病理改变的关系.方法 临床和病理确诊为HMD的早产儿,因HMD而在生后6 h内接受机械通气及高浓度氧(FiO20.6～1.0)治疗无效死亡者30例.按接受机械通气/高氧治疗时间的长短,分1～3 d、4～8 d、9～16 d和>16 d共4组,其中13例患儿同时接受了PS治疗.以无肺部疾病的5例早产儿为对照.应用免疫组织化学方法检测尸检肺组织标本中SP-C及Ki67的表达.多组间比较采用方差分析及g检验.结果 机械通气/高氧治疗的HMD早产儿,其不同时期肺组织的病理表现符合HMD向支气管肺发育不良转变的病理特征.肺组织SP-C表达定位于Ⅱ型肺泡上皮细胞,Ki67表达主要定位于肺、支气管上皮细胞和肺成纤维细胞.机械通气/高氧治疗1～3 d,SP-C及Ki67表达的平均光度值分别为0.1576±0.0327和0.1929±0.0403,较对照组(0.1891±0.0253、0.2297±0.0380)明显降低(P均<0.05);4 d后,SP-C及Ki67表达均逐渐升高,至9～16 d左右达高峰,分别为(0.2410±0.0225、0.2987±0.0116).PS治疗组与无PS治疗组肺组织SP-C及Ki67表达差异无统计学意义(t值分别为2.007和0.458,P均>0.05).结论 SP-C及Ki67表达改变参与了HMD早产儿机械通气/高氧治疗后肺组织的病理发展过程;PS治疗对SP-C及Ki67表达无明显影响.     

肺透明膜病早产儿尸检肺组织肺表面活性蛋白-C及Ki67的表达

Objective To determine the expression of surfactant protein-c (SP-C) and Ki67 in autopsy lung tissues of premature infants died of hyaline membrane disease (HMD) who were exposed to mechanical ventilation and high oxygen concentrations/pulmonary surfactant (PS). The possible influence of surfactant on the expression of SP-C and Ki67 was also investigated. Methods Thirty preterm infants diagnosed as HMD by clinical data and pathology were selected. Mechanical ventilation and supplemental oxygen (FiO2 0.6-1.0) were given to these infants within 6 hours after birth. According to the duration of ventilation at high oxygen concentrations, all subjects were diveded into four groups: ventilation for 1-3 days, 4-8 days, 9-16 days and >16 days. Five premature infants died within 1 day after delivery for none pulmonary reasons served as controls. The expression of SP-C and Ki67 in lungs were detected by immunobistochemistry. Results The pulmonary pathology in these HMD infants at different phases was consisitent with the main features of different stages during the progress from HMD towards bronchopulmonary dysplasia. The positive staining of SP-C was restricted to type Ⅱ alveolar epithelial cells, and Ki67 positive were preferentially localized in nuclei of alveolar and bronchiolar epithelial cells and fihroblasts. Compared with the control group, the expression of SP-C and Ki67 in HMD infants decreased significantly after 1-3 days of ventialation, but increased after 4 days and reached the peak value after 9-16 days. The expression of SP-C and Ki67 in control group, 1-3 days and 9-16 days of ventialation were 0. 1891±0. 0253, 0. 1576±0. 0327 and 0. 2271±0. 0238 for SP-C and 0. 2297±0. 0380, 0.1929±0. 0403 and 0. 2849±0. 0368 for Ki67, respectively. No significant difference in the expression of SP-C and Ki67 was found between infants treated with PS and those without (P>0.05). Conclusions SP-C and Ki67 may have participated in the pulmonary pathological process in ventilated/oxygen treated preterm infants with HMD, and exogenous surfactant had no effect on the expression of SP-C and Ki67.     

肺透明膜病早产儿尸检肺组织肺表面活性蛋白-C及Ki67的表达

Objective To determine the expression of surfactant protein-c (SP-C) and Ki67 in autopsy lung tissues of premature infants died of hyaline membrane disease (HMD) who were exposed to mechanical ventilation and high oxygen concentrations/pulmonary surfactant (PS). The possible influence of surfactant on the expression of SP-C and Ki67 was also investigated. Methods Thirty preterm infants diagnosed as HMD by clinical data and pathology were selected. Mechanical ventilation and supplemental oxygen (FiO2 0.6-1.0) were given to these infants within 6 hours after birth. According to the duration of ventilation at high oxygen concentrations, all subjects were diveded into four groups: ventilation for 1-3 days, 4-8 days, 9-16 days and >16 days. Five premature infants died within 1 day after delivery for none pulmonary reasons served as controls. The expression of SP-C and Ki67 in lungs were detected by immunobistochemistry. Results The pulmonary pathology in these HMD infants at different phases was consisitent with the main features of different stages during the progress from HMD towards bronchopulmonary dysplasia. The positive staining of SP-C was restricted to type Ⅱ alveolar epithelial cells, and Ki67 positive were preferentially localized in nuclei of alveolar and bronchiolar epithelial cells and fihroblasts. Compared with the control group, the expression of SP-C and Ki67 in HMD infants decreased significantly after 1-3 days of ventialation, but increased after 4 days and reached the peak value after 9-16 days. The expression of SP-C and Ki67 in control group, 1-3 days and 9-16 days of ventialation were 0. 1891±0. 0253, 0. 1576±0. 0327 and 0. 2271±0. 0238 for SP-C and 0. 2297±0. 0380, 0.1929±0. 0403 and 0. 2849±0. 0368 for Ki67, respectively. No significant difference in the expression of SP-C and Ki67 was found between infants treated with PS and those without (P>0.05). Conclusions SP-C and Ki67 may have participated in the pulmonary pathological process in ventilated/oxygen treated preterm infants with HMD, and exogenous surfactant had no effect on the expression of SP-C and Ki67.     

肺透明膜病早产儿尸检肺组织肺表面活性蛋白-C及Ki67的表达

Objective To determine the expression of surfactant protein-c (SP-C) and Ki67 in autopsy lung tissues of premature infants died of hyaline membrane disease (HMD) who were exposed to mechanical ventilation and high oxygen concentrations/pulmonary surfactant (PS). The possible influence of surfactant on the expression of SP-C and Ki67 was also investigated. Methods Thirty preterm infants diagnosed as HMD by clinical data and pathology were selected. Mechanical ventilation and supplemental oxygen (FiO2 0.6-1.0) were given to these infants within 6 hours after birth. According to the duration of ventilation at high oxygen concentrations, all subjects were diveded into four groups: ventilation for 1-3 days, 4-8 days, 9-16 days and >16 days. Five premature infants died within 1 day after delivery for none pulmonary reasons served as controls. The expression of SP-C and Ki67 in lungs were detected by immunobistochemistry. Results The pulmonary pathology in these HMD infants at different phases was consisitent with the main features of different stages during the progress from HMD towards bronchopulmonary dysplasia. The positive staining of SP-C was restricted to type Ⅱ alveolar epithelial cells, and Ki67 positive were preferentially localized in nuclei of alveolar and bronchiolar epithelial cells and fihroblasts. Compared with the control group, the expression of SP-C and Ki67 in HMD infants decreased significantly after 1-3 days of ventialation, but increased after 4 days and reached the peak value after 9-16 days. The expression of SP-C and Ki67 in control group, 1-3 days and 9-16 days of ventialation were 0. 1891±0. 0253, 0. 1576±0. 0327 and 0. 2271±0. 0238 for SP-C and 0. 2297±0. 0380, 0.1929±0. 0403 and 0. 2849±0. 0368 for Ki67, respectively. No significant difference in the expression of SP-C and Ki67 was found between infants treated with PS and those without (P>0.05). Conclusions SP-C and Ki67 may have participated in the pulmonary pathological process in ventilated/oxygen treated preterm infants with HMD, and exogenous surfactant had no effect on the expression of SP-C and Ki67.     

肺透明膜病早产儿尸检肺组织肺表面活性蛋白-C及Ki67的表达

Objective To determine the expression of surfactant protein-c (SP-C) and Ki67 in autopsy lung tissues of premature infants died of hyaline membrane disease (HMD) who were exposed to mechanical ventilation and high oxygen concentrations/pulmonary surfactant (PS). The possible influence of surfactant on the expression of SP-C and Ki67 was also investigated. Methods Thirty preterm infants diagnosed as HMD by clinical data and pathology were selected. Mechanical ventilation and supplemental oxygen (FiO2 0.6-1.0) were given to these infants within 6 hours after birth. According to the duration of ventilation at high oxygen concentrations, all subjects were diveded into four groups: ventilation for 1-3 days, 4-8 days, 9-16 days and >16 days. Five premature infants died within 1 day after delivery for none pulmonary reasons served as controls. The expression of SP-C and Ki67 in lungs were detected by immunobistochemistry. Results The pulmonary pathology in these HMD infants at different phases was consisitent with the main features of different stages during the progress from HMD towards bronchopulmonary dysplasia. The positive staining of SP-C was restricted to type Ⅱ alveolar epithelial cells, and Ki67 positive were preferentially localized in nuclei of alveolar and bronchiolar epithelial cells and fihroblasts. Compared with the control group, the expression of SP-C and Ki67 in HMD infants decreased significantly after 1-3 days of ventialation, but increased after 4 days and reached the peak value after 9-16 days. The expression of SP-C and Ki67 in control group, 1-3 days and 9-16 days of ventialation were 0. 1891±0. 0253, 0. 1576±0. 0327 and 0. 2271±0. 0238 for SP-C and 0. 2297±0. 0380, 0.1929±0. 0403 and 0. 2849±0. 0368 for Ki67, respectively. No significant difference in the expression of SP-C and Ki67 was found between infants treated with PS and those without (P>0.05). Conclusions SP-C and Ki67 may have participated in the pulmonary pathological process in ventilated/oxygen treated preterm infants with HMD, and exogenous surfactant had no effect on the expression of SP-C and Ki67.     

肺透明膜病早产儿尸检肺组织肺表面活性蛋白-C及Ki67的表达

Objective To determine the expression of surfactant protein-c (SP-C) and Ki67 in autopsy lung tissues of premature infants died of hyaline membrane disease (HMD) who were exposed to mechanical ventilation and high oxygen concentrations/pulmonary surfactant (PS). The possible influence of surfactant on the expression of SP-C and Ki67 was also investigated. Methods Thirty preterm infants diagnosed as HMD by clinical data and pathology were selected. Mechanical ventilation and supplemental oxygen (FiO2 0.6-1.0) were given to these infants within 6 hours after birth. According to the duration of ventilation at high oxygen concentrations, all subjects were diveded into four groups: ventilation for 1-3 days, 4-8 days, 9-16 days and >16 days. Five premature infants died within 1 day after delivery for none pulmonary reasons served as controls. The expression of SP-C and Ki67 in lungs were detected by immunobistochemistry. Results The pulmonary pathology in these HMD infants at different phases was consisitent with the main features of different stages during the progress from HMD towards bronchopulmonary dysplasia. The positive staining of SP-C was restricted to type Ⅱ alveolar epithelial cells, and Ki67 positive were preferentially localized in nuclei of alveolar and bronchiolar epithelial cells and fihroblasts. Compared with the control group, the expression of SP-C and Ki67 in HMD infants decreased significantly after 1-3 days of ventialation, but increased after 4 days and reached the peak value after 9-16 days. The expression of SP-C and Ki67 in control group, 1-3 days and 9-16 days of ventialation were 0. 1891±0. 0253, 0. 1576±0. 0327 and 0. 2271±0. 0238 for SP-C and 0. 2297±0. 0380, 0.1929±0. 0403 and 0. 2849±0. 0368 for Ki67, respectively. No significant difference in the expression of SP-C and Ki67 was found between infants treated with PS and those without (P>0.05). Conclusions SP-C and Ki67 may have participated in the pulmonary pathological process in ventilated/oxygen treated preterm infants with HMD, and exogenous surfactant had no effect on the expression of SP-C and Ki67.