| 陈志君,卢凯珊,陈广明,钟丽娟,黄云丽.改良微创肺泡表面活性物质技术对极早早产儿呼吸窘迫综合征患儿Th1/Th2细胞因子含量及心肌损伤指标的影响[J].,2022,(11):2066-2070 |
| 改良微创肺泡表面活性物质技术对极早早产儿呼吸窘迫综合征患儿Th1/Th2细胞因子含量及心肌损伤指标的影响 |
| Effects of Modified Minimally Invasive Pulmonary Surfactant Administration on the Content of Th1/Th2 Cytokines and Myocardial Injury Indexes in Very Premature Infants with Respiratory Distress Syndrome |
| 投稿时间：2021-11-04 修订日期：2021-11-26 |
| DOI：10.13241/j.cnki.pmb.2022.11.012 |
| 中文关键词: 改良微创肺泡表面活性物质技术 气管插管注入肺泡表面活性物质技术 呼吸窘迫综合征患儿 Th1/Th2细胞因子 心肌损伤 |
| 英文关键词: Improved minimally invasive pulmonary surfactant administration Tracheal intubation pulmonary surfactant administration Respiratory distress syndrome Th1/Th2 cytokines Myocardial injury |
| 基金项目:广东省中山市社会公益与基础研究项目（2020B1049） |
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| 中文摘要: |
| 摘要 目的：观察应用改良微创肺泡表面活性物质技术对极早早产儿呼吸窘迫综合征患儿Th1/Th2细胞因子含量及心肌损伤指标的影响。方法：以自2018年1月-2020年3月于本院院收治的104例极早早产儿呼吸窘迫综合征患儿为研究对象，按随机数字表法分为研究组（52例，给予改良微创肺泡表面活性物质技术治疗）和对照组（52例，给予气管插管-肺表面活性物质-拔管（INSURE）技术）。观察两组患儿治疗前、治疗7 d后的Th1/Th2细胞因子含量及心肌损伤指标，统计治疗后不良反应及并发症的发生率。结果：（1）干预前，两组患儿干扰素-γ（IFN-γ）、白介素-4（IL-4）及IFN-γ/IL-4含量比较，差异不显著（P＞0.05）；治疗后，两组IFN-γ及IFN-γ/IL-4含量均较治疗前降低，而IL-4含量明显上升；其中研究组IFN-γ及IFN-γ/IL-4含量均低于对照组，IL-4含量高于对照组，差异显著（P<0.05）。（2）干预前，两组患儿肌酸激酶同工酶（CK-MB）、肌酐蛋白（cTnI）及乳酸脱氢酶（LDH）含量比较，差异不显著（P＞0.05）；治疗后，两组CK-MB、cTnI及LDH含量均较治疗前降低，其中研究组CK-MB、cTnI及LDH含量均明显低于对照组（P<0.05）。（3）在治疗过程中，两组不良反应中心动过缓、经皮血氧饱和度（SpO2）下降、72 h内机械通气率及再次使用肺泡表面活性物质率比较，差异不显著（P＞0.05）。（4）在治疗过程中，两组并发症中早产儿视网膜病、坏死性小肠结肠炎、支气管肺发育不良、气胸、脑室内出血及死亡率比较，差异不显著（P＞0.05）。结论：应用改良微创肺泡表面活性物质技术可有效调节极早早产儿呼吸窘迫综合征患儿免疫功能，保护心肌细胞，且安全性高，值得临床推广使用。 |
| 英文摘要: |
| ABSTRACT Objective: To observe the effect of modified minimally invasive pulmonary surfactant administration on the content of Th1/Th2 cytokines and myocardial injury indicators in very premature infants with respiratory distress syndrome. Methods: A total of 104 cases of very premature infants with respiratory distress syndrome who were admitted to our hospital from January 2018 to March 2020 were selected as the research object. Study groups were divided according to random number table method (52 cases, given modified minimally invasive pulmonary surfactant treatment) and control group (52 cases, given tracheal intubation to inject pulmonary surfactant treatment). Observe the Th1/Th2 cytokine content and myocardial injury indexes of the two groups of very premature infants before treatment and 7 days after treatment, and count the incidence of adverse reactions and complications after treatment. Results: (1) Before intervention, the content of IFN-γ, IL-4 and IFN-γ/IL-4 in the two groups were not different(P>0.05); after treatment, IFN-γ and IFN-γ/IL-4 in the 2 groups were lower than those before treatment, while the content of IL-4 increased; the content of IFN-γ and IFN-γ/IL-4 in the research group were lower than the control group, and the content of IL-4 was higher than the control group(P<0.05). (2) Before intervention, the two groups of children with CK-MB, cTnI and LDH levels were not different(P>0.05), after treatment, the contents of CK-MB, cTnI and LDH in the two groups were lower than before treatment. The contents of CK-MB, cTnI and LDH of the study group were lower than the control group (P<0.05). (3) During the course of treatment, there was no difference in bradycardia, decrease in SpO2, mechanical ventilation rate within 72 hours, and the rate of reuse of pulmonary surfactant in the two groups(P>0.05). (4) During the course of treatment, there were no differences in premature infant retinopathy, necrotizing enterocolitis, bronchopulmonary dysplasia, pneumothorax, intraventricular hemorrhage, and mortality during the treatment(P>0.05). Conclusion: The application of modified minimally invasive pulmonary surfactant administration can effectively regulate the immune function in very premature infants with respiratory distress syndrome, protect cardiomyocytes, and have high safety, which is worthy of clinical promotion. |
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