肺表面活性蛋白B基因多态性与新生儿肺支气管发育不良的危险相关性

目的探讨新生儿肺支气管发育不良与肺表面活性蛋白B基因多态性的相关性。方法选2008~2014年接受治疗的肺支气管发育不良患儿35例(观察组),并纳入同期收治的早产儿(无肺支气管发育不良)45例作为对照组。所有受试者均为汉族人。分析对比两组患儿肺表面活性蛋白B(SPB)基因多态性,并分析与肺支气管发育不良的危险相关性。结果观察组SPB的18A等位基因频率显著高于对照组(χ2=7.740,P=0.005)。两组受试者1580C及1580T等位基因频率相比较差异无统计学意义(P0.05)。Logistics回归分析显示,携带SPB(18A)基因是支气管肺发育不良的独立危险因素(OR:3.612;CI:2.213~4.643)。结论汉族人群中,肺表面活性蛋白B基因与肺支气管发育不良相关,SPB(18A)基因可能是肺支气管发育不良的危险因素。     

机械通气、肺表面活性物质联合布地奈德防治早产儿支气管肺发育不良的临床效果

目的 探究机械通气、肺表面活性物质联合布地奈德防治早产儿支气管肺发育不良（BPD）的临床效果。方法 将本院收治的98例新生儿呼吸窘迫综合征早产儿,根据治疗方法不同分为对照(1)组（38例,机械通气）、对照(2)组（30例,机械通气+肺表面活性物质）和观察组（30例,机械通气+肺表面活性物质+布地奈德）。比较三组的治疗效果。结果 纠正胎龄36周时,观察组的BPD严重程度低于对照(1)组和对照(2)组（P<0.05）。干预1周后,三组的pH、动脉血氧分压（PaO2）高于干预前,动脉血二氧化碳分压（PaCO2）低于干预前,且观察组优于对照(1)组和对照(2)组（P<0.05）。干预6个月后,观察组的身高、体重高于对照(1)组和对照(2)组,头围大于对照(1)组和对照(2)组（P<0.05）。干预1周后,观察组的胱抑素C水平高于对照(1)组和对照(2)组,白细胞介素-33水平低于对照(1)组和对照(2)组（P<0.05）。结论 机械通气、肺表面活性物质联合布地奈德防治早产儿BPD效果显著。     

肺表面活性物质配合布地奈德对新生儿通气改善及支气管肺发育不良预防效果的观察

目的探析肺表面活性物质(PS)配合布地奈德对新生儿通气改善及支气管肺发育不良的预防效果。方法选取我院2014年9月～2017年9月收治的早产儿90例,按随机投掷法分为观察组和对照组各45例。对照组予以猪肺磷脂注射液气管插管内滴入治疗,观察组在此基础上联合布地奈德混悬液气管插管内滴入。观察两组患儿血气分析、氧合指数、机械通气时间、总吸氧时间及支气管肺发育不良发生率。结果治疗后观察组血pH值、PO_2及氧合指数明显高于对照组,PCO_2低于对照组,差异有统计学意义(P0.05);观察组机械通气时间及总吸氧时间均明显短于对照组,差异有统计学意义(P0.05);观察组支气管肺发育不良发生率为6.67%,明显低于对照组,差异有统计学意义(P0.05)。结论 PS配合布地奈德可明显降低新生儿支气管肺发育不良的发生率,改善早产儿肺功能,显著缩短辅助通气时间。     

肺表面活性物质替代治疗与支气管肺发育不良的关系

目的 探讨不同剂量肺表面活性物质(PS)替代治疗早产儿肺透明膜病(HMD)与发生支气管肺发育不良(BPD)的关系.方法 将2005年1月至2007年12月入住本院新生儿科并出现生后进行性呼吸困难且胸片提示考虑诊断为HMD的403例早产儿,依据家属经济条件使用旨剂PS情况分三组进行前瞻性的临床对照研究:低剂量PS组(L-PS组,剂量≤100 mg/kg,n=188)、高剂量PS组(H-PS组,剂量>100mg/kg,n=94)和未使用PS组(N-PS组, n=121);采用自身对照和组间比较观察PS治疗6 h后患儿吸氧浓度(FiO2)、肺部氧合功能,以及三组问观察总氧疗时间、机械通气时间、再次插管机械通气率、住院时间和BPD发生情况.结果 与N-PS组患儿比较,在给予Ps治疗6 h后,L-PS组和H-PS组两组患儿的FiO2,OI明显降低,PO2和a/A PO2比值均明显升高(P<0.05);氧疗时间和机械通气时间均明显缩短,较少发生再次插管机械通气(P<0.05);且以H-PS组患儿改变显著,差异均具有统计学意义(P<0.05).H-PS组患儿BPD发生(11例,11.7%)明显低于N-PS组(29例,24.0%),差异具有统计学意义(F1-3=4.267,P=0.006);L-PS组BPD发牛(34例,18.1%)虽然低于N-PS组,但差异无统计学意义(F1-2=1.354,P=0.062).结论 PS替代治疗能有效地改善肺部氧合功能,减少机械通气时间和再次插管机械通气发生率,且以大剂量(>100mg/kg)的效果更明显,并能有效地预防BPD的发生.     

肺表面活性物质替代治疗与支气管肺发育不良的关系

Objective To explore, the effect of different dosage of pulmonary surfactant (PS) on the inci-dence of bronchopulmanary dysplasia. Method Four hundred and three premature infants with hyaline membrane disease were divided into 3 groups according to the dose of PS: low-dose group (L-PS group, ≤ 100 mg/kg, n =188) ,high-dose group(H-PS group, > 100 mg/kg, n = 94) and no-PS group (N-PS group, n = 121). The frac-tional inspired oxygen(FiO2) and ptlmonary oxygenating function before and after 6 hours treatment were observed and the durations of oxygen therapy and mechanical ventilation, frequency of repeated intubafion, length of hospi-talization and the incidence of BPD were compared among the three groups. Results After 6 hours PS administra-tion, the FiO2,oxygen index and duration of oxygen therapy and mechanical ventilation were significantly decreased (P <0.05), while PO2 and the arterio-alveolar partial pressure of oxygen were significantly increased (P <0.05)in the H-PS and L-PS groups, compared with the N-PS group. Compared with the L-PS and N-PS groups,the H-PS group showed a decreased incidence of BPD. Conclusions PS administration could improve the pul-monary oxygenation and prevent the development of BPD, especially in high-dose.     

肺表面活性物质替代治疗与支气管肺发育不良的关系

Objective To explore, the effect of different dosage of pulmonary surfactant (PS) on the inci-dence of bronchopulmanary dysplasia. Method Four hundred and three premature infants with hyaline membrane disease were divided into 3 groups according to the dose of PS: low-dose group (L-PS group, ≤ 100 mg/kg, n =188) ,high-dose group(H-PS group, > 100 mg/kg, n = 94) and no-PS group (N-PS group, n = 121). The frac-tional inspired oxygen(FiO2) and ptlmonary oxygenating function before and after 6 hours treatment were observed and the durations of oxygen therapy and mechanical ventilation, frequency of repeated intubafion, length of hospi-talization and the incidence of BPD were compared among the three groups. Results After 6 hours PS administra-tion, the FiO2,oxygen index and duration of oxygen therapy and mechanical ventilation were significantly decreased (P <0.05), while PO2 and the arterio-alveolar partial pressure of oxygen were significantly increased (P <0.05)in the H-PS and L-PS groups, compared with the N-PS group. Compared with the L-PS and N-PS groups,the H-PS group showed a decreased incidence of BPD. Conclusions PS administration could improve the pul-monary oxygenation and prevent the development of BPD, especially in high-dose.     

肺表面活性物质替代治疗与支气管肺发育不良的关系

Objective To explore, the effect of different dosage of pulmonary surfactant (PS) on the inci-dence of bronchopulmanary dysplasia. Method Four hundred and three premature infants with hyaline membrane disease were divided into 3 groups according to the dose of PS: low-dose group (L-PS group, ≤ 100 mg/kg, n =188) ,high-dose group(H-PS group, > 100 mg/kg, n = 94) and no-PS group (N-PS group, n = 121). The frac-tional inspired oxygen(FiO2) and ptlmonary oxygenating function before and after 6 hours treatment were observed and the durations of oxygen therapy and mechanical ventilation, frequency of repeated intubafion, length of hospi-talization and the incidence of BPD were compared among the three groups. Results After 6 hours PS administra-tion, the FiO2,oxygen index and duration of oxygen therapy and mechanical ventilation were significantly decreased (P <0.05), while PO2 and the arterio-alveolar partial pressure of oxygen were significantly increased (P <0.05)in the H-PS and L-PS groups, compared with the N-PS group. Compared with the L-PS and N-PS groups,the H-PS group showed a decreased incidence of BPD. Conclusions PS administration could improve the pul-monary oxygenation and prevent the development of BPD, especially in high-dose.     

肺表面活性物质替代治疗与支气管肺发育不良的关系

Objective To explore, the effect of different dosage of pulmonary surfactant (PS) on the inci-dence of bronchopulmanary dysplasia. Method Four hundred and three premature infants with hyaline membrane disease were divided into 3 groups according to the dose of PS: low-dose group (L-PS group, ≤ 100 mg/kg, n =188) ,high-dose group(H-PS group, > 100 mg/kg, n = 94) and no-PS group (N-PS group, n = 121). The frac-tional inspired oxygen(FiO2) and ptlmonary oxygenating function before and after 6 hours treatment were observed and the durations of oxygen therapy and mechanical ventilation, frequency of repeated intubafion, length of hospi-talization and the incidence of BPD were compared among the three groups. Results After 6 hours PS administra-tion, the FiO2,oxygen index and duration of oxygen therapy and mechanical ventilation were significantly decreased (P <0.05), while PO2 and the arterio-alveolar partial pressure of oxygen were significantly increased (P <0.05)in the H-PS and L-PS groups, compared with the N-PS group. Compared with the L-PS and N-PS groups,the H-PS group showed a decreased incidence of BPD. Conclusions PS administration could improve the pul-monary oxygenation and prevent the development of BPD, especially in high-dose.     

肺表面活性物质替代治疗与支气管肺发育不良的关系

Objective To explore, the effect of different dosage of pulmonary surfactant (PS) on the inci-dence of bronchopulmanary dysplasia. Method Four hundred and three premature infants with hyaline membrane disease were divided into 3 groups according to the dose of PS: low-dose group (L-PS group, ≤ 100 mg/kg, n =188) ,high-dose group(H-PS group, > 100 mg/kg, n = 94) and no-PS group (N-PS group, n = 121). The frac-tional inspired oxygen(FiO2) and ptlmonary oxygenating function before and after 6 hours treatment were observed and the durations of oxygen therapy and mechanical ventilation, frequency of repeated intubafion, length of hospi-talization and the incidence of BPD were compared among the three groups. Results After 6 hours PS administra-tion, the FiO2,oxygen index and duration of oxygen therapy and mechanical ventilation were significantly decreased (P <0.05), while PO2 and the arterio-alveolar partial pressure of oxygen were significantly increased (P <0.05)in the H-PS and L-PS groups, compared with the N-PS group. Compared with the L-PS and N-PS groups,the H-PS group showed a decreased incidence of BPD. Conclusions PS administration could improve the pul-monary oxygenation and prevent the development of BPD, especially in high-dose.     

肺表面活性物质替代治疗与支气管肺发育不良的关系

Objective To explore, the effect of different dosage of pulmonary surfactant (PS) on the inci-dence of bronchopulmanary dysplasia. Method Four hundred and three premature infants with hyaline membrane disease were divided into 3 groups according to the dose of PS: low-dose group (L-PS group, ≤ 100 mg/kg, n =188) ,high-dose group(H-PS group, > 100 mg/kg, n = 94) and no-PS group (N-PS group, n = 121). The frac-tional inspired oxygen(FiO2) and ptlmonary oxygenating function before and after 6 hours treatment were observed and the durations of oxygen therapy and mechanical ventilation, frequency of repeated intubafion, length of hospi-talization and the incidence of BPD were compared among the three groups. Results After 6 hours PS administra-tion, the FiO2,oxygen index and duration of oxygen therapy and mechanical ventilation were significantly decreased (P <0.05), while PO2 and the arterio-alveolar partial pressure of oxygen were significantly increased (P <0.05)in the H-PS and L-PS groups, compared with the N-PS group. Compared with the L-PS and N-PS groups,the H-PS group showed a decreased incidence of BPD. Conclusions PS administration could improve the pul-monary oxygenation and prevent the development of BPD, especially in high-dose.     

肺表面活性物质替代治疗与支气管肺发育不良的关系

Objective To explore, the effect of different dosage of pulmonary surfactant (PS) on the inci-dence of bronchopulmanary dysplasia. Method Four hundred and three premature infants with hyaline membrane disease were divided into 3 groups according to the dose of PS: low-dose group (L-PS group, ≤ 100 mg/kg, n =188) ,high-dose group(H-PS group, > 100 mg/kg, n = 94) and no-PS group (N-PS group, n = 121). The frac-tional inspired oxygen(FiO2) and ptlmonary oxygenating function before and after 6 hours treatment were observed and the durations of oxygen therapy and mechanical ventilation, frequency of repeated intubafion, length of hospi-talization and the incidence of BPD were compared among the three groups. Results After 6 hours PS administra-tion, the FiO2,oxygen index and duration of oxygen therapy and mechanical ventilation were significantly decreased (P <0.05), while PO2 and the arterio-alveolar partial pressure of oxygen were significantly increased (P <0.05)in the H-PS and L-PS groups, compared with the N-PS group. Compared with the L-PS and N-PS groups,the H-PS group showed a decreased incidence of BPD. Conclusions PS administration could improve the pul-monary oxygenation and prevent the development of BPD, especially in high-dose.     

肺表面活性物质替代治疗与支气管肺发育不良的关系

Objective To explore, the effect of different dosage of pulmonary surfactant (PS) on the inci-dence of bronchopulmanary dysplasia. Method Four hundred and three premature infants with hyaline membrane disease were divided into 3 groups according to the dose of PS: low-dose group (L-PS group, ≤ 100 mg/kg, n =188) ,high-dose group(H-PS group, > 100 mg/kg, n = 94) and no-PS group (N-PS group, n = 121). The frac-tional inspired oxygen(FiO2) and ptlmonary oxygenating function before and after 6 hours treatment were observed and the durations of oxygen therapy and mechanical ventilation, frequency of repeated intubafion, length of hospi-talization and the incidence of BPD were compared among the three groups. Results After 6 hours PS administra-tion, the FiO2,oxygen index and duration of oxygen therapy and mechanical ventilation were significantly decreased (P <0.05), while PO2 and the arterio-alveolar partial pressure of oxygen were significantly increased (P <0.05)in the H-PS and L-PS groups, compared with the N-PS group. Compared with the L-PS and N-PS groups,the H-PS group showed a decreased incidence of BPD. Conclusions PS administration could improve the pul-monary oxygenation and prevent the development of BPD, especially in high-dose.     

肺表面活性物质替代治疗与支气管肺发育不良的关系

Objective To explore, the effect of different dosage of pulmonary surfactant (PS) on the inci-dence of bronchopulmanary dysplasia. Method Four hundred and three premature infants with hyaline membrane disease were divided into 3 groups according to the dose of PS: low-dose group (L-PS group, ≤ 100 mg/kg, n =188) ,high-dose group(H-PS group, > 100 mg/kg, n = 94) and no-PS group (N-PS group, n = 121). The frac-tional inspired oxygen(FiO2) and ptlmonary oxygenating function before and after 6 hours treatment were observed and the durations of oxygen therapy and mechanical ventilation, frequency of repeated intubafion, length of hospi-talization and the incidence of BPD were compared among the three groups. Results After 6 hours PS administra-tion, the FiO2,oxygen index and duration of oxygen therapy and mechanical ventilation were significantly decreased (P <0.05), while PO2 and the arterio-alveolar partial pressure of oxygen were significantly increased (P <0.05)in the H-PS and L-PS groups, compared with the N-PS group. Compared with the L-PS and N-PS groups,the H-PS group showed a decreased incidence of BPD. Conclusions PS administration could improve the pul-monary oxygenation and prevent the development of BPD, especially in high-dose.     

肺表面活性物质替代治疗与支气管肺发育不良的关系

Objective To explore, the effect of different dosage of pulmonary surfactant (PS) on the inci-dence of bronchopulmanary dysplasia. Method Four hundred and three premature infants with hyaline membrane disease were divided into 3 groups according to the dose of PS: low-dose group (L-PS group, ≤ 100 mg/kg, n =188) ,high-dose group(H-PS group, > 100 mg/kg, n = 94) and no-PS group (N-PS group, n = 121). The frac-tional inspired oxygen(FiO2) and ptlmonary oxygenating function before and after 6 hours treatment were observed and the durations of oxygen therapy and mechanical ventilation, frequency of repeated intubafion, length of hospi-talization and the incidence of BPD were compared among the three groups. Results After 6 hours PS administra-tion, the FiO2,oxygen index and duration of oxygen therapy and mechanical ventilation were significantly decreased (P <0.05), while PO2 and the arterio-alveolar partial pressure of oxygen were significantly increased (P <0.05)in the H-PS and L-PS groups, compared with the N-PS group. Compared with the L-PS and N-PS groups,the H-PS group showed a decreased incidence of BPD. Conclusions PS administration could improve the pul-monary oxygenation and prevent the development of BPD, especially in high-dose.     

支气管肺发育不良早产儿的护理

支气管肺发育不良（bronchopulmonary dysplasia,BPD）是指任何氧依赖（〉21%）超过28 d的新生儿,是早产儿尤其是小早产儿呼吸系统常见疾病,具有独特的临床、影像学及组织学特征[1].肺发育不成熟、急性肺损伤、损伤后异常修复是引起BPD的3个关键环节.近年来,由于早产儿存活率提高,BPD发生率也有逐年增加的趋势,并成为新生儿重症监护病房（NICU）最为棘手的问题之一,也是婴儿期慢性呼吸系统疾病的主要病因,严重影响早产儿存活率及生活质量[1].2012年6月我院NICU收治了1例发生BPD的极低出生体重儿,现将护理总结如下.     

血清25羟基维生素D、白细胞介素-6水平与早产儿支气管肺发育不良的关系

目的 探讨血清25羟基维生素D[25 hydroxyvitamin D,25(OH)D]、白细胞介素-6(interleukin-6,IL-6)水平与早产儿支气管肺发育不良(bronchopulmonary dysplasia,BPD)的关系.方法 回顾性分析2016年1月至2019年1月河北省保定市妇幼保健院新生儿科...     

支气管肺发育不良的研究进展

支气管肺发育不良(bronchopulmonary dysplasia,BPD)是早产儿最常见的严重呼吸系统疾病。随着外源性肺表面活性物质在临床广泛应用,经典型BPD发生率降低,新型BPD发生率增多,发病机制主要是在遗传易感性的基础上,宫内和出生后的多种损伤机制引起肺损伤。本文对BPD的研究新进展进行综述。     

肺纤维化患者血清及诱导痰肺表面活性蛋白水平测定及意义

目的检测特发性肺纤维化患者急性加重期血清及诱导痰肺表面活性蛋白D(SP-D)水平并探讨其临床治疗意义。方法选择特发性肺纤维化患者急性加重期住院治疗26例,分别收集纳入患者入院时及治疗后病情缓解血清及诱导痰液标本,采用酶联免疫吸附试验检测血清及诱导痰SP-D水平。选择42例健康人群作为对照组。结果特发性肺纤维化患者急性加重期及病情缓解期血清SP-D平均水平分别为(196±82)、(125±69)ng/mL,健康对照组为(96±47)ng/mL,诱导痰SP-D平均水平为(153±71)、(106±64)ng/mL,急性加重期与缓解期及健康对照组SP-D水平比较差异有统计学意义(P0.05)。结论血清SP-D检测可作为特发性肺纤维化患者急性加重诊断的生物学指标。     

慢性阻塞性肺疾病患者血清和痰液中表面活性蛋白D的水平及临床意义

目的:探讨慢性阻塞性肺疾病(chronic obstructive pulmonary disease,AECOPD)患者血清和痰液中表面活性蛋白D(surfactant protein D,SP-D)的水平和临床意义。方法:选取急性加重期COPD(acute exacerbation of COPD,AECOPD)患者34例(A组)、稳定期COPD患者37例(B组)、有嗜烟史的健康人30例(C组)、无嗜烟史的健康人30例(D组)。分别检测4组血清和痰液中的SP-D水平,并分析AECOPD患者血清和痰液SP-D水平的相关性。结果:A、B、C、D组的血清SP-D水平依次为(165.09±16.72)、(126.48±15.64)、(72.85±8.62)、(54.70±7.29)ng/mL,痰液SP-D水平依次为(109.03±18.95)、(133.28±16.36)、(260.04±47.91)、(665.89±117.49)ng/mL;血清和痰液SP-D水平在4组间的差异均有统计学意义(P0.05)。AECOPD患者的血清SP-D水平和痰液SP-D水平呈负相关(r=-0.698,P0.05)。结论:AECOPD患者的血清、痰液SP-D水平呈负相关。血清、痰液SP-D水平的监测有助于临床AECOPD病情的评估。     

地塞米松治疗早产儿支气管肺发育不良的护理

目的：探讨地塞米松治疗早产儿支气管肺发育不良的临床疗效,总结其护理措施。方法选择2013年1月到12月我院新生儿监护室收治的35例支气管肺发育不良早产儿,对其予以小剂量地塞米松静脉注射治疗,并予以一般护理、保持呼吸道通畅、合理氧疗、院内感染的预防与护理、合理喂养、地塞米松用药护理等相关护理。结果35例早产儿治愈32例,好转3例,治疗后 MAP、FiO2、PH、PCO2均较治疗前明显降低(P<0.05);PO2则较治疗前明显上升(P<0.05)。35例早产儿应用地塞米松治疗3 d 后肺部分泌物、哮鸣音明显减少,用药5 d基本消失。结论地塞米松治疗结合护理干预是治疗早产儿支气管肺发育不良成功的重要保证。