Neonatal Department, Jining No.1 People's Hospital, Shandong, China.
Eur Rev Med Pharmacol Sci. 2017 Oct;21(19):4357-4361.
To investigate and discuss the effect of early treatment with pulmonary surfactant (PS) on oxygenation functions in neonates with acute respiratory distress syndrome (ARDS), to understand the expression trend of serum transforming growth factor-beta 1 (TGF-β1) and bone morphogenetic protein 7 (BMP-7) in children with neonatal respiratory distress syndrome (NRDS), and to provide help for early prevention and treatment of NRDS.
All the children were treated with mechanical ventilation; among them, 25 NRDS children who were given PS within 12 h after birth were selected as PS group, and 25 NRDS children who were never given PS were selected as conventional mechanical ventilation (CMV) group. Enzyme-linked immunosorbent assay (ELISA) was used to detect the expressions of serum TGF-β1 and BMP-7 in the two groups of children and monitor their oxygenation function indexes in 0, 1, 3, and 7 d after birth, respectively.
The content of serum TGF-β1 and BMP-7 in children of both PS group and CMV group trended to be higher at 1 d after birth while it was decreased at 7 d after birth compared with that in other days. The TGF-β1 content at 3 and 7 d after birth and the BMP-7 expression level at 7 d after birth in CMV group were significantly higher than those in PS group (p<0.05). After treatment, the values of oxygenation index (OI) and respiratory index (RI) at different time points (6, 12, 24, 48 h) in PS group were lower than those in CMV group (p<0.05). The mechanical ventilation duration in PS group (81±25 h) was decreased compared with that in CMV group (102±24 h); the oxygenation time in PS group (99±37 h) was less than that in CMV group (122±28 h); the number of cases of complications in PS group and CMV group was 3 (12%) and 6 (24%), respectively, and the effective rates of treatment were 96.0% and 84.0%, respectively (p<0.05).
Early application of PS combined with mechanical ventilation can remarkably improve lung oxygenation and compliance, suppress inflammatory responses, and effectively treat the NRDS. Monitoring the changes of serum BMP-7 and TGF-β1 is very important for treatment and prognosis assessment of the NRDS.
探讨和研究肺表面活性物质（PS）早期治疗对急性呼吸窘迫综合征（ARDS）新生儿氧合功能的影响，了解新生儿呼吸窘迫综合征（NRDS）患儿血清转化生长因子-β1（TGF-β1）和骨形态发生蛋白 7（BMP-7）的表达趋势，为 NRDS 的早期预防和治疗提供帮助。
所有患儿均采用机械通气治疗；其中，将出生后 12 h 内给予 PS 的 25 例 NRDS 患儿作为 PS 组，从未给予 PS 的 25 例 NRDS 患儿作为常规机械通气（CMV）组。采用酶联免疫吸附试验（ELISA）检测两组患儿血清 TGF-β1 和 BMP-7 的表达，并分别于出生后 0、1、3、7 d 监测其氧合功能指标。
PS 组和 CMV 组患儿血清 TGF-β1 和 BMP-7 含量在出生后 1 d 呈升高趋势，在出生后 7 d 呈下降趋势，与其他天数相比差异有统计学意义（P<0.05）。CMV 组患儿在出生后 3、7 d 的 TGF-β1 含量和出生后 7 d 的 BMP-7 表达水平明显高于 PS 组（P<0.05）。治疗后，PS 组患儿在不同时间点（6、12、24、48 h）的氧合指数（OI）和呼吸指数（RI）值均低于 CMV 组（P<0.05）。PS 组患儿机械通气时间（81±25 h）短于 CMV 组（102±24 h）；PS 组患儿氧疗时间（99±37 h）短于 CMV 组（122±28 h）；PS 组和 CMV 组并发症发生例数分别为 3 例（12%）和 6 例（24%），治疗有效率分别为 96.0%和 84.0%（P<0.05）。
PS 联合机械通气早期应用可显著改善肺氧合和顺应性，抑制炎症反应，有效治疗 NRDS。监测血清 BMP-7 和 TGF-β1 的变化对 NRDS 的治疗和预后评估非常重要。
