肺表面活性物质在儿童急性呼吸窘迫综合征的应用

肺表面活性物质(pulmonary surfactant,PS)是由Ⅱ型肺泡上皮细胞合成分泌的脂质蛋白混合物,主要功能是降低肺泡气-液界面表面张力.急性呼吸窘迫综合征(acute respiratory distress syndrome,ARDS)时多种原因引起PS的量和质出现变化,导致其功能异常.外源性PS替代治疗可以改善儿童ARDS肺部气体交换,但提高存活率作用不肯定.这可能与ARDS病因、PS成分、给药方法、时机、剂量及次数等不同有关.目前不推荐PS作为儿童ARDS的常规治疗方法.

The use of pulmonary surfactant in children with acute respiratory distress syndrome

Pulmonary surfactant is a complex mixture of lipoproteins synthesized,secreted and recy-cled by type Ⅱ alveolar cells. The primary function of PS is to minimize the surface tension at the alveolar air-liquid interface. Surfactant dysfunction with quantitative and qualitative abnormalities of both phospholipids and proteins are characteristics of patients with acute respiratory distress syndrome ( ARDS ) . Exogenous surfactant replacement shows consistent improvements in gas exchange,but had limited success in improving survival. These may be due to variety of aetiologies in ARDS、surfactant compositiones, delivery methods, optimal time and doses. At this time,surfactant therapy cannot be recommended as routine therapy in pediatric ARDS.