布地奈德联合猪肺磷脂注射液对重度新生儿呼吸窘迫综合征患儿肺功能的影响

Effects of budesonide combined with Poractant Alfa Injection on pulmonary function in children with severe neonatal respiratory distress syndrome

目的探讨吸入用布地奈德混悬液联合猪肺磷脂注射液对重度新生儿呼吸窘迫综合征患儿肺功能的影响。方法选取2016年8月—2018年7月南京市大厂医院收治的重度新生儿呼吸窘迫综合征(NRDS)患儿61例为研究对象,根据随机数字表法分为两组。对照组给予猪肺磷脂注射液联合机械通气治疗,100 mg/kg气管内给药,用药时升温至37℃摇匀,用无菌注射器抽取。观察组在对照组的基础上给予吸入用布地奈德混悬液0.25 mg/kg雾化吸入。比较两组患儿的临床治疗效果、肺功能相关指标及血清铁蛋白(SF)和纤溶酶原激活物抑制剂-1(PAI-1)表达水平。结果观察组的总有效率为93.55%,高于对照组的73.33%,组间差异有统计学意义(P<0.05)。治疗前两组患儿动脉血氧分压(p O2)、动脉二氧化碳分压(p CO2)、吸氧浓度(FiO2)和氧合指数(OI)无统计学差异;治疗后p O2和OI显著升高,p CO2和FiO2显著下降,同组治疗前后比较差异有统计学意义(P<0.05);观察组p O2和OI显著高于对照组,p CO2显著低于对照组,组间差异有统计学意义(P<0.05)。两组治疗前SF和PAI-1表达水平无统计学差异;治疗后SF和PAI-1均显著降低,同组治疗前后比较差异有统计学意义(P<0.05);且观察组低于对照组,差异有统计学意义(P<0.05)。结论吸入用布地奈德混悬液联合猪肺磷脂注射液可显著降低重度新生儿呼吸窘迫综合征患儿的SF和PAI-1表达水平,改善患儿肺功能,提高临床治疗效果。

Objective To investigate the effects of Budesonide Suspension for Inhalation combined with Poractant Alfa Injection on pulmonary function in children with severe neonatal respiratory distress syndrome.Methods 61 cases of children with severe neonatal respiratory distress syndrome(NRDS)were selected from August 2016 to July 2018 in Nanjing Dachang Hospital were divided into two groups according to random number table method.The control group given Poractant Alfa Injection combined with mechanical ventilation therapy,and intratracheal administration of 100 mg/kg was given.The medication was warmed up to 37℃,shaken and extracted with sterile syringe.The observation group given Budesonide Suspension for Inhalation 0.25 mg/kg aerosol inhalation on the basis of control group.The clinical therapeutic effects,related parameters of lung function and serum SF,PAI-1 expression level were compared between two groups.Results The total effective rate of the observation group was 93.55%,which was significantly higher than 73.33%of the control group(P<0.05).p O2,p CO2,FiO2 and OI were no statistical difference between two groups before treatment.After treatment,p O2 and OI were significantly increased,but p CO2 and FiO2 were significantly decreased,and the difference was statistically significant in the same group(P<0.05).After treatment,p O2 and OI in observation group were significantly higher than those in the control group,p CO2 was significantly lower than that of control group,with significant difference between two groups(P<0.05).There was no statistically significant difference in SF and PAI-1 expression between the two groups before treatment.After treatment,SF and PAI-1 were significantly reduced,and the difference was statistically significant in the same group(P<0.05).And the observation group was lower than the control group,with significant difference between two groups(P<0.05).Conclusion Budesonide Suspension for Inhalation combined with Poractant Alfa Injection can significantly reduce the expression of SF and PAI-1 in children with severe neonatal respiratory distress syndrome,improve the lung function,and improve the clinical treatment effect.