Tsanova Asya, Jordanova Albena, Stoyanova Vishnya, Tasheva-Terzieva Elena, Ivanova Krasimira, Lalchev Zdravko
Faculty of Medicine, St. Kl. Ohridski University of Sofia, 1407, Sofia, Bulgaria.
Faculty of Biology, St. Kl. Ohridski University of Sofia, 1164, Sofia, Bulgaria.
Heliyon. 2019 Dec 18;5(12):e03072. doi: 10.1016/j.heliyon.2019.e03072. eCollection 2019 Dec.
One of the main causes for the higher mortality among risk newborn children (including preterm infants) is neonatal respiratory distress syndrome (NRDS), which develops as a result of primary deficiency or secondary inactivation of alveolar surfactant (AS). Therefore, fast and early diagnostics of risk newborns lung maturity is crucial for their prompt therapy.
Gastric aspirates (GA) were collected from 77 infants divided into three groups: a control of 38 healthy full-term infants; 16 prematurely newborns with NRDS, and 23 prematurely born infants after fertilization and corticosteroid therapy (CST). Surface parameters: equilibrium (γ), maximal (γ) and minimal (γ) surface tension, and the shape of hysteresis curves of GA monolayers were measured by axisymmetric drop shape analysis (ADSA) of a pending drop. In addition, the morphology of GA monolayers was studied by Brewster angle microscopy (BAM).
Our results showed that only γ values were reliable and were significantly lower in full-term infants, as compared to the risk neonates. The results obtained were proved by the shape of hysteresis curves of GA surface active films. BAM images of GA monolayers from NRDS group showed impaired surface morphology due to the surfactant insufficiency, as compared to the control group. Corticosteroid therapy improved both GA surface characteristics and monolayer morphology.
GAs analyses by ADSA and BAM are fast and informative approaches for lung maturity assessment. In addition, the corticosteroid therapy applied improved all GAs surface parameters due to AS maturation.
风险新生儿（包括早产儿）死亡率较高的主要原因之一是新生儿呼吸窘迫综合征（NRDS），它是由于肺泡表面活性物质（AS）原发性缺乏或继发性失活所致。因此，快速早期诊断风险新生儿的肺成熟度对于其及时治疗至关重要。
从77名婴儿中收集胃吸出物（GA），这些婴儿分为三组：38名健康足月儿作为对照组；16名患有NRDS的早产儿，以及23名经受精和皮质类固醇治疗（CST）后的早产儿。表面参数：通过悬滴的轴对称滴形分析（ADSA）测量GA单层的平衡（γ）、最大（γ）和最小（γ）表面张力以及滞后曲线的形状。此外，通过布鲁斯特角显微镜（BAM）研究GA单层的形态。
我们的结果表明，只有γ值是可靠的，与风险新生儿相比，足月儿的γ值显著更低。GA表面活性膜的滞后曲线形状证实了所得结果。与对照组相比，NRDS组GA单层的BAM图像显示由于表面活性剂不足导致表面形态受损。皮质类固醇治疗改善了GA的表面特征和单层形态。
通过ADSA和BAM分析GA是评估肺成熟度的快速且信息丰富的方法。此外，由于AS成熟，应用的皮质类固醇治疗改善了所有GA的表面参数。
