两种肺表面活性物质治疗新生儿呼吸窘迫综合征疗效的比较研究

A comparison of effects of natural and synthetic surfactants on neonatal respiratory distress syndrome

目的 比较天然与合成制剂的外源性肺表面活性物质 (PS)治疗新生儿呼吸窘迫综合征 (NRDS)的疗效和安全性。方法 将 14例NRDS随机分为 2组 ,每组 7例。一组使用Calsurf(天然PS) ,一组使用Exosurf (合成PS)。比较两组用药前后血气指标、呼吸机参数变化、用药后机械通气时间、总用氧时间、肺部X线改变及并发症的发生率。结果 两组用药后 72h氧合及肺功能指标较用药前明显改善 ,差异显著 (P <0 0 5 ) ;呼吸机参数(除PEEP外 )明显下降 ,差异有显著性意义 (P <0 0 5 )。两组间在用药前及用药后 2h、8h、2 4h、72h血气指标及呼吸机参数比较差异均无显著性意义 (P >0 0 5 )。用药后胸片分值的改变、机械通气和总用氧时间、并发症发生率两组间的差异亦无显著性意义 (P >0 0 5 )。结论 天然制剂PS与合成制剂PS治疗NRDS临床疗效及安全性等方面基本一致。

Objective To compare the efficacy and safety of natural Calsurf surfactant with those of synthetic Exosurf surfactant in premature infants with respiratory distress syndrome (NRDS).Methods A total of 7 premature infants received synthetic surfactant and 7 premature infants received natural surfactant. The surfactant was administered in one dose by endotracheal intubation.Blood gas index,ventilator parameters,the duration of ventilator dependence and hours of oxygen requirement,thoracic X-ray changes and incidence of complication before and after surfactant administration were analyzed and compared.Results The oxygenization and lung function of the two study groups showed significant improvements at 72h after surfactant administration in comparison with those before surfactant therapy,respectively( P<0 05).The ventilator parameters (except for PEEP) acquired were also lower at 72h after surfactant administration than those before surfactant therapy in both study groups (P<0 05).There were no significant differences in the blood gas and ventilator parameters before and 2h、8h、24h、72h after surfactant administration between natural surfactant group and synthetic surfactant group(P>0 05).No statistically significant differences were found in thoracic X-ray scores, the duration of ventilation dependence, hours of oxygen requirement and incidence of complications after surfactant administration between the two groups (P>0 05).Conclusion The use of synthetic surfactant seems to offer the same efficacy and safety in comparison with its natural counterpart.