维生素D联合布地奈德预防早产儿支气管肺发育不良效果及对肺功能的影响

Prevention effect of vitamin D combined with Budesonide on bronchopulmonary dysplasia and its influences on pulmonary function in premature infants

目的探讨维生素D联合布地奈德预防早产儿支气管肺发育不良(BPD)的效果及对肺功能的影响。方法选取2022年7月至2023年5月宜春市人民医院新生儿科收治的60例BPD高危早产儿作为研究对象,采用随机数字表法分为A组、B组和C组,各20例;A组给予氧疗、营养支持等常规对症治疗,B组在A组基础上给予常规剂量(400 U/d)维生素D联合布地奈德治疗,C组在A组基础上给予大剂量(800 U/d)维生素D联合布地奈德治疗;比较三组BPD发生情况、呼吸支持情况、潮气呼吸肺功能、免疫球蛋白3项及不良反应情况。结果C组BPD发生率低于A组,差异有统计学意义(P<0.017)。B组和C组氧疗时间均低于A组,差异有统计学意义(P<0.05)。三组早产儿治疗后的达峰时间比(TPEF/TE)、达峰容积比(VPEF/VE)、50%潮气量时呼气流速(TEF50)、75%潮气量时呼气流速(TEF75)均高于本组治疗前,B组和C组早产儿治疗后的TPEF/TE、VPEF/VE、TEF50和TEF75水平均高于A组,差异有统计学意义(P<0.05)。B组和C组早产儿治疗后的免疫球蛋白A(IgA)、免疫球蛋白G(IgG)和免疫球蛋白M(IgM)水平均高于本组治疗前,C组早产儿治疗后的IgA、IgG和IgM水平高于A组和B组,差异有统计学意义(P<0.05)。结论维生素D联合布地奈德预防BPD效果明显,其中大剂量维生素D相比常规剂量在呼吸支持及肺功能方面未见明显改善,但有助于提高免疫功能。

Objective To explore the prevention effect of vitamin D combined with Budesonide on bronchopulmonary dysplasia(BPD)and its influences on pulmonary function in premature infants.Methods A total of 60 high-risk premature infants with BPD admitted to Department of Neonatology,Yichun People's Hospital were enrolled between July 2022 and May 2023 were selected as the research objects.According to random number table method,they were divided into group A,group B and group C,with 20 cases in each group.The group A was given routine symptomatic treatments(oxygen therapy,nutritional support),while group B and group C were given routine dose(400 U/d)and high dose(800 U/d)of vitamin D combined with Budesonide on the basis of group A,respectively.The occurrence of BPD,respiratory support,tidal breath pulmonary function,immunoglobulins and adverse reactions were compared among the three groups.Results The incidence of BPD in group C was lower than that in group A,and the difference was statistically significant(P<0.017).The oxygen therapy time in groups B and C was shorter than that in group A,and the difference was statistically significant(P<0.05).After treatment,time to tidal peak expiratory flow to total expiratory time ratio(TPEF/TE),volume at tidal peak expiratory flow to total expiratory volume ratio(VPEF/VE),the 50%tidal volume during expiratory flow(TEF50)and the 75%tidal volume during expiratory flow(TEF75)in three groups were higher than before treatment,the levels of TPEF/TE,VPEF/VE,TEF50 and TEF75 in groups B and C after treatment were higher than those in group A,and the differences were statistically significant(P<0.05).After treatment,levels of immunoglobulin A(IgA),immunoglobulin G(IgG)and immunoglobulin M(IgM)in groups B and C were higher than before treatment,the levels of IgA,IgG and IgM in group C after treatment were higher than those in groups A and B,and the differences were statistically significant(P<0.05).Conclusion Vitamin D combined with Budesonide has obvious prevention effect on BPD.Compared with routine dose,high dose of vitamin D can not significantly improve respiratory support or pulmonary function,but which is beneficial to improve immune function.