机械通气对新生儿气道灌洗液中肺表面活性物质蛋白A的影响

目的:观察机械通气对新生儿气道灌洗液中肺表面活性物质蛋白A(SP-A)的影响,探讨其在机械通气肺损伤中的作用及其临床意义。方法:将36例使用机械通气新生儿设为机械通气组,31例未使用机械通气新生儿设为非机械通气组,动态观察机械通气组患儿在机械通气后1 h、24 h、48 h、72 h气道灌洗液中SP-A在各时段的变化,非机械通气组也以同样时段气道灌洗液,用W estern dot b lot免疫印迹法检测气道灌洗液中SP-A水平。应用SPSS 10.0统计学软件进行统计学处理,所有数值以均数±标准差(x±s)表示;相关性分析应用直线相关公式计算关联系数r值。结果:机械通气组患儿气道灌洗液中SP-A水平显著降低,与非机械通气组比较差异有显著性(P<0.05,P<0.01),且SP-A水平与使用机械通气天数相关。机械通气后48 h气道灌洗液中SP-A水平出现明显变化,提示机械通气后48 h患儿可能开始出现肺损伤。结论:动态观察新生儿机械通气时气道灌洗液中SP-A水平可能有助于监测机械通气肺损伤的发生,对临床的诊断和治疗具有重要指导意义。

Influence of mechanical ventilation on tracheal aspirate fluid surfactant- associated proteins- A levels in neonates

Objective:To explore the tracheal aspirate fluid surfactant-associated proteins-A(SP-A) levels and the development of ventilation-induced lung injury(VILI) that occurs in neonate,and to investigate the effect of mechanical ventilation on tracheal aspirate fluid SP-A response of newborns.Methods:The study was carried out in 36 neonates used mechanical ventilation and in 31 neonates unused mechanical ventilation in Neonate Intensive Care Unit(NICU).Tracheal aspirate fluid SP-A levels were observed dynamically in 1h,24h,48h,72h after using mechanical ventilation by western dot blot.Tracheal aspirate fluid SP-A levels in unusing mechanical ventilation group were determined at the same time.We took the statistic analysis with SPSS10.0 statistic software.The All values were presented as mean±SD(x±s) and the correlation analysis was taken with linear correlation formula.Results:Tracheal aspirate fluid SP-A levels in mechanical ventilation groups were obviously decreased than these of control group(P<0.05,P<0.01,respectively).We found that tracheal aspirate fluid SP-A levels correlated with the use of mechanical ventilation and the days requiring mechanical ventilation.Tracheal aspirate fluid SP-A levels in neonates on 48 h after mechanical ventilation had obviously changed.Conclusion:Tracheal aspirate fluid SP-A levels in neonates on 48h after mechanical ventilation may help us to monitor the development of VILI.Therefore,evaluating tracheal aspirate fluid SP-A levels in neonate after mechanical ventilation may help monitor the development of VILI and the clinical diagnosis and treatment of VILI.