肺表面活性物质联合NCPAP对新生儿呼吸衰竭血清ET-1及CC16的影响

doi:10.3877/cma.j.issn.1674-6902.2020.05.009

目的

探讨肺表面活性物质联合鼻塞式正压通气(NCPAP)对新生儿呼吸衰竭血清ET-1及CC16的影响。

方法

选取2017年1月至2018年11月来院就诊患新生儿呼吸衰竭患儿共114例，采用随机数表分组随机分为观察组60例和对照组54例。两组患儿入组后均予对症治疗，对照组患儿予NCPAP，观察组患儿在此基础上加予肺表面活性物质治疗，均连续治疗3 d。比较两组总有效率、治疗前后的血清内皮素-1(ET-1)、Clara细胞蛋白-16(CC16)、血氧分压(PaO₂)、动脉血二氧化碳分压(PaCO₂)、动脉血氧饱和度(SaO₂)以及不良反应发生率。

结果

观察组总有效率81.67%(49/60)，高于对照组64.81%(35/54)，差异有统计学意义(P<0.05)。治疗后，两组患儿血清ET-1、CC16水平均明显降低，且观察组低于对照组(P<0.05)。治疗后两组患儿PaO₂、SaO₂均明显上升、PaCO₂明显下降(P<0.05)。观察组治疗后的PaO₂、SaO₂高于对照组，PaCO₂低于对照组，差异有统计学意义(P<0.05)。观察组和对照组不良反应发生率分别为8.33%(5/60)、9.26%(5/54)，差异无统计学意义(P>0.05)。

结论

新生儿呼吸衰竭采用肺表面活性物质联合NCPAP治疗效果更好，能有效降低血清ET-1及CC16水平。

关键词: 肺表面活性物质, 鼻塞式正压通气, 新生儿呼吸衰竭, 内皮素-1, Clara细胞蛋白-16

Objective

To investigate the effect of pulmonary surfactant combined with NCPAP on ET-1 and CC16 in neonates with respiratory failure.

Methods

from January 2017 to November 2018, a total of 117 patients with neonatal respiratory failure were randomly divided into two groups: observation group 60 cases and control group 54 cases. Both groups received routine nursing and symptomatic treatment. The control group was treated with NCPAP to control the symptoms of respiratory failure. The observation group was treated with pulmonary surfactant on this basis. The two groups were treated for 3 consecutive days. The changes of PaO₂, PaCO₂ and SaO₂ levels before and after treatment were compared After treatment, the adverse reactions of the two groups were recorded and counted. The changes of serum ET-1 and CC16 before and after treatment were compared.

Results

there was no significant difference in PaO₂, PaCO₂ and SaO₂ between the two groups before and after the treatment. The above indexes of the two groups were significantly improved after the treatment, and the patients in the observation group were significantly improved compared with the patients in the control group, the results were statistically significant(P<0.05); the total effective rate of the observation group was 82.46%, the total effective rate of the control group was 64.91%, the effective rate of the observation group was significantly higher than that of the control group, the results were There was statistical significance; there was no significant difference in the incidence of adverse reactions between the two groups; there was no significant difference in the expression of serum ET-1 and CC16 between the two groups before the treatment; after the treatment, the expression of serum ET-1 and CC16 in the two groups were significantly reduced, and the observation group was significantly lower than the control group, the results were statistically significant.

Conclusion

pulmonary surfactant combined with NCPAP is more effective in the treatment of neonatal respiratory failure, and can effectively reduce the expression of serum ET-1 and CC16.

Key words: Pulmonary surfactant, Nasal continuous positive airway pressure, Neonatal respiratory failure, ET-1, CC16

表1 两组患儿治疗前后血清ET-1及CC16的比较(±s)

组　别	例数	ET-1(ng/L)				CC16(ng/L)
组　别	例数	治疗前	治疗后	t值	P值	治疗前	治疗后	t值	P值
观察组	60	77.81±3.06	48.17±1.67	65.860	0.000	0.55±0.62	0.18±0.17	4.458	0.000
对照组	54	77.03±1.65	62.62±1.65	45.379	0.000	0.53±1.05	0.31±0.23	3.372	0.001
t值		1.667	46.391			0.125	3.521
P值		0.098	0.000			0.901	0.001

表1 两组患儿治疗前后血清ET-1及CC16的比较(±s)

组　别	例数	ET-1(ng/L)				CC16(ng/L)
组　别	例数	治疗前	治疗后	t值	P值	治疗前	治疗后	t值	P值
观察组	60	77.81±3.06	48.17±1.67	65.860	0.000	0.55±0.62	0.18±0.17	4.458	0.000
对照组	54	77.03±1.65	62.62±1.65	45.379	0.000	0.53±1.05	0.31±0.23	3.372	0.001
t值		1.667	46.391			0.125	3.521
P值		0.098	0.000			0.901	0.001

表2 两组患儿治疗前后氧合指标比较(±s)

组　别	例数	PaO₂(mmHg)		PaCO₂(mmHg)		SaO₂(%)
组　别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
观察组	60	46.81±1.11	82.17±0.67^a	60.15±2.62	38.08±1.77^a	0.72±0.06	0.91±0.08^a
对照组	54	46.93±1.32	64.14±0.91^a	60.27±1.05	45.01±1.23^a	0.71±0.45	0.84±0.03^a
t值		0.527	121.260	0.320	24.017	0.171	6.056
P值		0.599	0.000	0.750	0.000	0.865	0.000

表2 两组患儿治疗前后氧合指标比较(±s)

组　别	例数	PaO₂(mmHg)		PaCO₂(mmHg)		SaO₂(%)
组　别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
观察组	60	46.81±1.11	82.17±0.67^a	60.15±2.62	38.08±1.77^a	0.72±0.06	0.91±0.08^a
对照组	54	46.93±1.32	64.14±0.91^a	60.27±1.05	45.01±1.23^a	0.71±0.45	0.84±0.03^a
t值		0.527	121.260	0.320	24.017	0.171	6.056
P值		0.599	0.000	0.750	0.000	0.865	0.000

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Effect of pulmonary surfactant combined with NCPAP on serum ET-1 and CC16 in neonates with respiratory failure

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Effect of pulmonary surfactant combined with NCPAP on serum ET-1 and CC16 in neonates with respiratory failure