LAC+USC Medical Center and Children's Hospital Los Angeles, Los Angeles, CA, USA.
J Perinatol. 2013 Feb;33(2):119-25. doi: 10.1038/jp.2011.125. Epub 2011 Sep 1.
The objective of this study is to compare all-cause in-hospital mortality in preterm infants with respiratory distress syndrome (RDS) treated with poractant alfa, calfactant or beractant.
A retrospective cohort study of 14 173 preterm infants with RDS, treated with one of three surfactants between 2005 and 2009, using the Premier Database was done. Multilevel, multivariable logistic regression modeling, adjusting for patient- and hospital-level factors was performed.
Calfactant treatment was associated with a 49.6% greater likelihood of death than poractant alfa (odds ratio (OR): 1.496, 95% confidence interval (CI): 1.014-2.209, P=0.043). Beractant treatment was associated with a non-significant 37% increase in mortality, compared with poractant alfa (OR: 1.370, 95% CI: 0.996-1.885, P=0.053). No differences in mortality were observed between calfactant and beractant treatment (OR: 1.092, 95% CI: 0.765-1.559, P=0.626).
Poractant alfa treatment for RDS was associated with a significantly reduced likelihood of death when compared with calfactant and a trend toward reduced mortality when compared with beractant.
本研究旨在比较使用猪肺磷脂、牛肺表面活性剂和葆丽能治疗呼吸窘迫综合征（RDS）的早产儿的全因住院死亡率。
这是一项回顾性队列研究，纳入了 2005 年至 2009 年间使用三种表面活性剂治疗的 14173 例 RDS 早产儿，使用 Premier 数据库。采用多水平、多变量逻辑回归模型，对患者和医院水平的因素进行调整。
与猪肺磷脂相比，牛肺表面活性剂治疗的死亡风险增加 49.6%（比值比（OR）：1.496，95%置信区间（CI）：1.014-2.209，P=0.043）。与猪肺磷脂相比，葆丽能治疗的死亡率增加了非显著的 37%（OR：1.370，95% CI：0.996-1.885，P=0.053）。但牛肺表面活性剂和葆丽能治疗之间的死亡率没有差异（OR：1.092，95% CI：0.765-1.559，P=0.626）。
与牛肺表面活性剂和葆丽能相比，猪肺磷脂治疗 RDS 可显著降低死亡率。
