肺泡表面活性物质联合双水平气道正压通气治疗新生儿呼吸窘迫综合征的临床疗效及对其血清TGF-β1和BMP-7表达水平的影响

Clinical effect of pulmonary surfactant combined with bilevel positive airway pressure in treatment of neonates with respiratory distress syndrome and the impact on expression levels of serum TGF-β1 and BMP-7

目的探讨肺泡表面活性物质(PS)联合双水平气道正压通气(BiPAP)治疗新生儿呼吸窘迫综合征(NRDS)的临床疗效及对其血清中转化生长因子-β1(TGF-β1)和骨形态发生蛋白-7(BMP-7)表达水平的影响,为临床诊治提供参考依据。方法将2015年1月-2017年4月佳木斯大学附属第一医院收治的80例NRDS患儿随机分为观察组及对照组;对照组采用BiPAP治疗,观察组在对照组治疗的基础上联合PS治疗;在治疗结束后对临床疗效进行评估;治疗前及治疗结束后1h记录患儿呼吸频率、心率、氧合指数指标,并记录不良反应;治疗前及治疗后24h检测患儿血清中TGF-β1及BMP-7水平。结果观察组临床疗效显著优于对照组,差异有统计学意义(P<0.05);治疗后患儿心率、呼吸显著降低,氧合指数显著升高,且观察组患儿心率、呼吸显著低于对照组,氧合指数显著高于对照组,差异有统计学意义(均P<0.05);治疗后两组患儿血清中TGF-β1及BMP-7水平均显著降低,且观察组显著低于对照组,差异有统计学意义(均P<0.05);观察组不良反应发生率显著低于对照组,差异有统计学意义(P<0.05)。结论采用PS联合BiPAP对NRDS患儿治疗后,可有效提高临床疗效并降低不良反应发生率,并可有效改善血清中TGF-β1及BMP-7水平。

Objective To explore the clinical effect of pulmonary surfactant ( PS) combined with bilevel positive airway pressure ( Bi- PAP) in treatment of neonatal respiratory distress syndrome ( NRDS) and the impact on expression levels of serum transforming growth factor-β1 ( TGF - β1 ) and bone morphogenetic protein - 7 ( BMP - 7 ) ,provide a reference basis for clinical diagnosis and treatment.Methods From January 2015 to April 2017,80 neonates with NRDS treated in the First Affiliated Hospital of Jiamusi University were randomly divided into observation group and control group.The patients in control group were treated with BiPAP,and the patients in observation group were treated with BiPAP combined with PS.The clinical effects in the two groups were evaluated after treatment.The related indexes ( respiratory rate,heart rate,and oxygenation index) before treatment and at one hour after treatment in the two groups were recorded.The adverse reactions were recorded.The levels of serum TGF-β1 and BMP-7 before treatment and at 24 hours after treatment in the two groups were detected.Results The clinical curative effect in observation group was significantly better than that in control group ( P< 0.05) .After treatment,heart rate and respiratory rate decreased significantly,oxygenation index increased significantly,heart rate and respiratory rate in observation group were statistically significantly lower than those in control group,while oxygenation index in observation group was statistically significantly higher than that in control group ( P<0.05) .After treatment,the levels of serum TGF-β1 and BMP-7 in the two groups decreased significantly,the levels of serum TGF-β1 and BMP-7 in observation group were statistically significantly lower than those in control group ( P<0.05) .The incidence rate of adverse reactions in observation group was statistically significantly lower than that in control group ( P<0.05) .Conclusion The combination of PS and BiPAP can effectively improve clinical efficacy and reduce incidence rate of adverse reactions in patients with NRDS,which can effectively improve serum levels of TGF-β1 and BMP-7.