肺表面活性物质联合BiPAP对早产儿呼吸窘迫综合征患儿血清HMGB-1、MIF-1及BMP-7的影响

Effects of Pulmonary Surfactant Combined with BiPAP on Serum HMGB-1,MIF-1 and BMP-7 in Premature Infants with Respiratory Distress Syndrome

目的:探讨肺表面活性物质(PS)联合双水平气道正压通气(Bi PAP)治疗早产儿呼吸窘迫综合征(NRDS)的疗效及对血清高迁移率族蛋白1(HMGB-1)、Ⅱ型肺泡细胞表面抗原(MIF-1)、骨形态发生蛋白-7(BMP-7)水平的影响。方法:选取徐州医科大学附属儿童医院于2015年3月~2019年3月期间收治的NRDS早产儿141例,根据随机数字表法将患儿分为对照组(n=70)和研究组(n=71),对照组给予Bi PAP治疗,研究组在对照组的基础上给予PS治疗,比较两组临床疗效、临床指标、血气分析指标、相关血清学指标以及并发症。结果:研究组治疗后临床总有效率较对照组升高(P<0.05)。研究组氧疗时间、机械通气时间、住院时间均较对照组缩短(P<0.05)。两组患儿治疗后酸碱度(pH)、动脉血氧分压(PaO2)均升高,且研究组高于对照组(P<0.05);动脉二氧化碳分压(PaCO2)降低,且研究组低于对照组(P<0.05)。两组患儿治疗后血清HMGB-1、MIF-1、BMP-7水平均降低,且研究组低于对照组(P<0.05)。两组并发症总发生率比较无统计学差异(P>0.05)。结论:PS联合Bi PAP治疗NRDS早产儿,疗效确切,可有效改善患儿临床指标、血气分析指标以及血清HMGB-1、MIF-1、BMP-7水平,且不增加并发症发生率,临床应用价值较高。

Objective:To investigate the efficacy of pulmonary surfactant(PS)combined with bi-level positive airway pressure(Bi PAP)in the treatment of respiratory distress syndrome(NRDS)in premature infants and its effects on serum high mobility group protein-1(HMGB-1),type II alveolar cell surface antigen(MIF-1)and bone morphogenetic protein-7(BMP-7).Methods:141 premature infant with NRDS admitted to Children’s Hospital Affiliated to Xuzhou Medical University from March 2015 to March 2019 were divided into control group(n=70)and study group(n=71)according to random number table method.The control group was treated with Bi PAP,while the study group was treated with PS on the basis of the control group.The clinical efficacy,clinical indicators,blood gas analysis indicators,serological indicators and complications were compared between the two groups.Results:After treatment,The total clinical effective rate of the study group was higher than that of the control group(P<0.05).The duration of oxygen therapy time,mechanical ventilation time and hospitalization time in the study group were shorter than those in the control group(P<0.05).After treatment,the acidity and alkalinity(pH)and arterial partial oxygen pressure(PaO2)of the two groups increased,and the study group was higher than the control group(P<0.05),while the arterial partial pressure of carbon dioxide(PaCO2)decreased,and the study group was lower than the control group(P<0.05).After treatment,HMGB-1,MIF-1 and BMP-7 in the two groups were all decreased,and those in the study group were lower than those in the control group(P<0.05).There was no significant difference in the total incidence of complications between the two groups(P>0.05).Conclusion:PS combined with Bi PAP in the treatment of NRDS preterm infants has definite curative effect.It can effectively improve the level of clinical indicators,blood gas analysis indicators and HMGB-1,MIF-1 and BMP-7,without increasing the incidence of complications,which has high clinical value.