不同种类肺表面活性物质治疗新生儿呼吸窘迫综合征的疗效比较

Comparisons of efficacy of different pulmonary surfactants for the treatment of neonatal respiratory distress syndrome

目的综合分析进口肺表面活性物质(pulmonary surfactant,PS)猪肺磷脂注射液(猪PS)与国产牛肺表面活性剂(牛PS)治疗新生儿呼吸窘迫综合征(NRDS)的临床疗效,以便科学选用。方法回顾分析2006年1月至2011年6月随机选用猪PS和牛PS治疗的180例Ⅳ级NRDS患儿(每组90例)的临床资料,比较两组胸片及不同时段血气分析结果改善、并发症的发生、住院时间及住院费用等。结果猪PS组有效率(97%)高于牛PS组(83%)(P<0.01);猪PS组治愈率(84%)亦高于牛PS组(66%)(P<0.01);猪PS组气胸发生率(3%)低于牛PS组(7%)(P<0.05);猪PS组住院时间(21±4 d)较牛PS组(23±4 d)短(P<0.05);两组平均住院总费用差异无统计学意义(P>0.05)。结论治疗Ⅳ级NRDS猪PS优于牛PS。

Objective To compare the clinical efficacy of imported pulmonary surfactant （PS） pig lung phospholipids injection （pig PS ） and domestic cattle lung surface-active agent （cattle PS ） for the treatment of neonatal respiratory distress syndrome （NRDS）. Methods A total of 180 cases of grade IV NRDS receiving pig PS （n = 90） or cattle PS treatment （n =90） were enrolled. The blood gas analysis and chest X-ray results and the incidence of complications after treatment, and hospitalization time and cost were compared between the two treatment groups. Results The efficiency rate in the pig PS group （97%） was higher than in the catle PS group （83%） （P 〈0.01 ）. The cure rate in the pig PS group was also higher than in the cattle PS group （84% vs 66% ; P 〈 0.01 ）. The incidence of pneumothorax in the pig PS group was lower than in the cattle PS group （3% vs 7% ; P 〈 0.05 ）. The hospitalization time in the pig PS group was shorter than in the cattle PS group （21±4 days vs 23 ±4 days; P 〈0.05）. There were no significant differences in the total hospitalization cost between the two groups. Conclusions Pig PS seems to be superior to cattle PS in the treatment of grade IV NRDS.