Soll R F, Horbar J D, Griscom N T, Barth R A, Lucey J F, Taeusch H W
Department of Pediatrics, University of Vermont College of Medicine, Burlington 05405.
Am J Perinatol. 1991 Mar;8(2):114-8. doi: 10.1055/s-2007-999358.
Radiographs of the chest (CXR) were evaluated in 35 of 41 infants enrolled in a randomized controlled trial of modified bovine surfactant extract (Surfactant-TA Tokyo-Tanabe) treatment. Infants between birthweight 1000 and 1500 gm with respiratory distress syndrome requiring mechanical ventilation and an inspired oxygen concentration 0.4 or greater were randomly assigned to either a single intratracheal dose of saline or surfactant-TA prior to 8 hours of age. Radiographs obtained prior to treatment and 24 hours after treatment were reviewed by a radiologist (N.T.G.) without knowledge of treatment group. Evaluation consisted of a score including criteria for inflation of the lungs, density of the lungs, and extent of air bronchograms. Pneumothorax, pulmonary interstitial emphysema, and asymmetric parenchymal involvement were noted as well. No significant difference in CXR scores were noted in the two groups, before or after treatment. There was a greater incidence of pneumothorax and pulmonary interstitial emphysema in the control infants, which supports the role of surfactant in preventing barotrauma. Increased incidence of asymmetric parenchymal involvement was noted in the surfactant-treated infants. Further study of the possibility of drug maldistribution is warranted.
在一项关于改良牛肺表面活性物质提取物（表面活性剂-TA，东京田边制药）治疗的随机对照试验中，对41名婴儿中的35名进行了胸部X光片（CXR）评估。出生体重在1000至1500克之间、患有呼吸窘迫综合征且需要机械通气、吸入氧浓度为0.4或更高的婴儿，在8小时龄之前被随机分配接受单次气管内注射生理盐水或表面活性剂-TA。由一名放射科医生（N.T.G.）在不知道治疗组的情况下，对治疗前和治疗后24小时获得的X光片进行评估。评估包括一个评分，其中包括肺膨胀、肺密度和支气管充气征范围的标准。同时也记录了气胸、肺间质肺气肿和不对称实质受累情况。两组在治疗前和治疗后的CXR评分均无显著差异。对照婴儿中气胸和肺间质肺气肿的发生率更高，这支持了表面活性物质在预防气压伤中的作用。在接受表面活性剂治疗的婴儿中，不对称实质受累的发生率有所增加。有必要进一步研究药物分布不均的可能性。
