牛肺表面活性物质与猪肺表面活性物质治疗早产儿呼吸窘迫综合征的临床疗效观察

中国临床药理学与治疗学 ›› 2012, Vol. 17 ›› Issue (1): 97-102.

牛肺表面活性物质与猪肺表面活性物质治疗早产儿呼吸窘迫综合征的临床疗效观察

董一慧, 袁显文, 李鹏

青岛市第八人民医院儿科,青岛 266000,山东

收稿日期:2011-10-11 修回日期:2011-12-06 出版日期:2012-01-26 发布日期:2012-02-16
作者简介:董一慧,女,在读硕士研究生,住院医师,研究方向:新生儿疾病。Tel: 13626391670 E-mail: dongyihui2011@126.com

Comparison of calsurf and curosurf on preterm infants respiratory distress syndrome

DONG Yi-hui, YUAN Xian-wen, LI Peng

Department of Pediatrics, the Eighth People's Hospital of Qingdao, Qingdao 266000,Shandong,China

Received:2011-10-11 Revised:2011-12-06 Online:2012-01-26 Published:2012-02-16

摘要/Abstract

摘要： 目的: 比较牛肺表面活性物质(珂立苏)与猪肺表面活性物质(固尔苏)治疗早产儿呼吸窘迫综合征的疗效和安全性。方法: 本院新生儿重症监护中心2008年1月-2011年8月诊治的120例呼吸窘迫综合征(RDS)早产患儿,随机分为珂立苏治疗组和固尔苏治疗组各60例,气管插管分别给予珂立苏和固尔苏治疗,比较两组治疗效果及并发症。结果: 珂立苏和固尔苏均对早产儿RDS有肯定的治疗效果,表现在明显改善机械通气参数、血气分析结果和胸部X线片RDS分级(P<0.05);固尔苏的治疗效果优于珂立苏,特别是机械通气和用氧时间较少(P<0.05);两组间早产儿相关并发症无统计学差异(P>0.05)。结论: 珂立苏和固尔苏对早产儿RDS均有肯定的治疗作用且安全性好,固尔苏有疗效优势但珂立苏相对较为经济。

关键词: 肺表面活性物质, 呼吸窘迫综合征, 早产儿, 疗效

Abstract: AIM: To evaluate and compare the efficacy and safety of pulmonary surfactant, calsurf and curosurf, on the treatment of preterm infant respiratory distress syndrome (RDS).METHODS: From January 2008 to August 2011,120 case of preterm infant RDS diagnosed and treated in the neonatal intensive care unit of our hospital were randomly devided into two groups, calsurf treatment group and curosurf treatment group, each including 60 cases, given calsurf and curosurf treatment though trachea cannula, respectively, observed the efficacy and complications.RESULTS: Both calsurf and curosurf had positive treatment effectiveness on RDS, represented for improvement the ventilator parameters, blood gas analysis results and RDS grade, respectively (P<0.05). The effects of curosurf was much better than calsurf especially for the duration of mechanical ventilation and oxygenization (P<0.05). There were no differences in complications of preterm infants between the two groups (P<0.05).CONCLUSION: Both calsurf and curosurf have positive effectiveness and good safety in the treatment of RDS, curosurf has efficacy advantage while calsurf has economic advantage.

Key words: Pulmonary surfactant, Respiratory distress syndrome, Preterm infant, Efficacy

中图分类号:

R722

董一慧, 袁显文, 李鹏. 牛肺表面活性物质与猪肺表面活性物质治疗早产儿呼吸窘迫综合征的临床疗效观察[J]. 中国临床药理学与治疗学, 2012, 17(1): 97-102.

DONG Yi-hui, YUAN Xian-wen, LI Peng. Comparison of calsurf and curosurf on preterm infants respiratory distress syndrome[J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2012, 17(1): 97-102.

参考文献

[1] Sweet D, Bevilacqua G, Carnielli V, et al. European consensus guidelines on the management of neonatal respiratory distress syndrome[J]. J Perinat Med, 2007, 35(3):175-186.
[2] 刘翠青, 马莉, 马海燕, 等. 机械通气联合肺表面活性物质治疗重症新生儿呼吸窘迫综合征168例临床分析[J]. 中国实用儿科杂志, 2010, 24(4):275-278.
[3] Rocha G, Saldanha J, Macedo I, et al. Respiratory support strategies for the preterm newborn - National survey 2008[J]. Rev Port Pneumol, 2009, 15(6):1043-1071.
[4] Miedema M, de Jongh FH, Frerichs I, et al. Changes in lung volume and ventilation during surfactant treatment in ventilated preterm infants[J]. Am J Respir Crit Care Med, 2011, 184(1):100-105.
[5] 徐国成, 李志奇. 肺表面活性物质的临床应用进展[J]. 中国临床药理学与治疗学, 2010, 15(7):827-831.
[6] 董声焕, 孙眉月, 寇同欣, 等. 肺表面活性剂(珂立苏)治疗新生儿呼吸窘迫综合征多中心临床试验[J]. 中国小儿急救医学, 2009, 16(2):120-124.
[7] Fujii AM, Patel SM, Allen R, et al. Poractant alfa and beractant treatment of very premature infants with respiratory distress syndrome[J]. J Perinatol, 30(10):665-670.
[8] Ramanathan R. Choosing a right surfactant for respiratory distress syndrome treatment[J]. Neonatology, 2009, 95(1):1-5.
[9] 金汉珍, 黄德珉, 宫希吉. 实用新生儿学[M]. 3版. 北京: 人民卫生出版社, 2004:421-428.
[10] 胡亚美, 江载芳. 诸福棠实用儿科学[M]. 7版. 北京: 人民卫生出版社, 2006:458-461.
[11] 周晓光, 罗先琼, 杨琳琳, 等. 肺表面活性物质治疗新生儿呼吸窘迫综合征的临床对照研究[J]. 中华儿科杂志, 2000, 38(8):490-493.
[12] Zhang JP, Wang YL, Wang YH, et al. Prophylaxis of neonatal respiratory distress syndrome by intra-amniotic administration of pulmonary surfactant[J]. Chin Med J (Engl), 2004, 117(1):120-124.
[13] Ramanathan R. Optimal ventilatory strategies and surfactant to protect the preterm lungs[J]. Neonatology, 2008, 93(4):302-308.
[14] 牛世平, 王小虎. 珂立苏联合鼻塞式气道正压通气治疗早产儿呼吸窘迫综合征的临床观察[J]. 中国新生儿科杂志, 2008, 23(1):41-42.
[15] 冯思国, 钟晓蓉. 国产及进口肺表面活性物质治疗新生儿呼吸窘迫综合征的疗效比较[J]. 中国临床药理学与治疗学, 2011, 16(3):296-299.
[16] 包志丹, 程锐, 邹芸苏, 等. 固尔苏与珂立苏治疗早产儿呼吸窘迫综合征疗效的比较研究[J]. 南京医科大学学报:自然科学版, 2010, 30(12):1748-1751.
[17] 刘晓峰. 固尔苏的有效性和安全性评价[J]. 药物与临床, 2009, 6(13):82-83.