Shinwell E S, Zmora E, Leven D, Berger I, Karplus M
Soroka Medical Center, Ben-Gurion University of the Negev, Beer Sheba.
Harefuah. 1992 Jul;123(1-2):1-4, 72.
A pilot study of the effect of exogenous surfactant (ES) on premature infants with respiratory distress syndrome (RDS) is reported. Each of the first 15 infants in this study received 200 mg/kg of natural surfactant (Curosurf) during the first day of life. Controls were 56 infants with RDS seen in the 15 months prior to the study. Within 5 minutes of starting ES, in all infants there was rapid and dramatic improvement in oxygenation and improvement in the average arterial/alveolar ratio of 169%. They had lower oxygen and ventilatory requirements than the control group throughout the first 5 days of life. No treated infant suffered from pulmonary air leak, while in the control group 21% developed pneumothorax and 11% had pulmonary interstitial emphysema. Mortality was 13% in the treated group as compared to 27% in the control group (p less than 0.01). There were no differences between the groups in the incidence of sepsis, patent ductus arteriosus, necrotizing enterocolitis, intraventricular hemorrhage, or bronchopulmonary dysplasia, nor were there side-effects of therapy. Dosage, timing and composition of the ideal surfactant are important questions for future studies.
报道了一项关于外源性表面活性剂（ES）对患有呼吸窘迫综合征（RDS）的早产儿影响的初步研究。本研究中前15名婴儿在出生第一天均接受了200mg/kg的天然表面活性剂（珂立苏）。对照组为在该研究前15个月内收治的56例患有RDS的婴儿。开始使用ES后5分钟内，所有婴儿的氧合情况迅速且显著改善，平均动脉/肺泡比值提高了169%。在出生后的前5天里，他们的氧气和通气需求均低于对照组。接受治疗的婴儿无一例发生肺空气泄漏，而对照组中21%发生气胸，11%发生肺间质肺气肿。治疗组的死亡率为13%，而对照组为27%（p<0.01）。两组在败血症、动脉导管未闭、坏死性小肠结肠炎、脑室内出血或支气管肺发育不良的发生率方面无差异，治疗也无副作用。理想表面活性剂的剂量、给药时间和成分是未来研究的重要问题。
