Griese M, Westerburg B, Potz C, Dietrich P
Kinderpoliklinik, Ludwig Maximilian University, Munich, Germany.
Biol Neonate. 1996;70(5):271-9. doi: 10.1159/000244376.
Small volume bronchoalveolar lavages from 10 infants (26.6 +/- 0.4 weeks gestational age) during postnatal nosocomial infection were fractioned by differential centrifugation into large (LA) and small (SA) surfactant aggregates. Before deterioration of the clinical status, the surface tension at minimum bubble radius (gamma min), as measured in a pulsating bubble surfactometer, was reduced to about 14 mN/m by LA and to about 22 mN/m by the corresponding SA. The gamma min of both LA and SA increased during clinical deterioration, was highest at the worst clinical state and returned during recovery to values in the range before deterioration. Respiratory support significantly correlated to gamma min at all times. In contrast, no correlation was observed for total protein or albumin content of the LA or SA fractions. The SA fraction was characterized by a 10-fold higher protein content than LA. These data demonstrate functional impairment of surfactant in subfractions during mechanical ventilation and nosocomial infection in preterm neonates that are not fully explained by inhibition with increasing amounts of total protein.
对10名出生后发生医院感染的婴儿（胎龄26.6±0.4周）进行小容量支气管肺泡灌洗，通过差速离心将其分为大（LA）和小（SA）表面活性剂聚集体。在临床状况恶化之前，在脉动气泡表面张力仪中测得的最小气泡半径处的表面张力（γmin），LA使其降至约14 mN/m，相应的SA使其降至约22 mN/m。在临床恶化期间，LA和SA的γmin均升高，在最差临床状态时最高，并在恢复过程中回到恶化前的范围值。呼吸支持在所有时间都与γmin显著相关。相比之下，未观察到LA或SA组分的总蛋白或白蛋白含量存在相关性。SA组分的特点是蛋白质含量比LA高10倍。这些数据表明，在机械通气和医院感染期间，早产儿表面活性剂亚组分存在功能损害，这不能完全用总蛋白量增加的抑制作用来解释。
