中国小儿急救医学
中國小兒急救醫學
중국소인급구의학
CHINESE PEDIATRIC EMERGENCY MEDICINE
2008年
2期
109-113
,共5页
刘淑华%刘翠青%夏耀方%张古英%赵建
劉淑華%劉翠青%夏耀方%張古英%趙建
류숙화%류취청%하요방%장고영%조건
胎粪吸入综合征%吸入一氧化氮%超氧化物歧化酶%丙二醛%总抗氧化能力
胎糞吸入綜閤徵%吸入一氧化氮%超氧化物歧化酶%丙二醛%總抗氧化能力
태분흡입종합정%흡입일양화담%초양화물기화매%병이철%총항양화능력
Meconium aspiration syndrome%Inhaled nitric oxide%Superoxide dismutase%Matonaldehyde%Total antioxidant capacity
目的 探讨吸入低浓度一氧化氮(iNO)对胎粪吸入综合征(MAS)患儿机体氧化-抗氧化平衡的影响.方法 将我院新生儿科病房的55例MAS患儿随机分为机械通气+iNO组(A组,n=25)、机械通气组(B组,n=30),并选择我院同期的健康足月新生儿为对照组(C组,n=30).iNO前A、B组均接受气管插管、气管内吸痰、机械通气及静脉滴注抗生素等一般治疗.A组于入院后1～2 h给予iNO治疗,分别在0、24、72 h监测各组患儿静脉血血清中超氧化物歧化酶(SOD)、丙二醛(MDA)、总抗氧化能力(T-AOC)水平.结果 三组患儿一般情况比较差异无显著性.随着NO吸入.A组SOD、T-AOC渐增高,MDA含量降低(P＜0.05).B组SOD在24 h降低,而在72 h呈增高改变,MDA含量变化与之相反,T-AOC呈渐增高改变(P＜0.05).A组机械通气时间及氧暴露时间分别为(77.38±13.97)h与(158.70±47.23)h,明显低于B组[(104.27±10.53)h与(202.15±61.92)h],差异有显著性(P＜0.05),但两组患儿病死率及气漏、肺出血、颅内出血(Ⅱ～Ⅳ级)的发生率差异无显著性(P＞0.05).结论 iNO可减少机械通气及氧暴露时间.MAS患儿体内存在不同程度的氧化-抗氧化失衡,iNO多显示抗氧化活性,有助于机体氧化-抗氧化平衡的调节,对机体具有保护性作用.
目的 探討吸入低濃度一氧化氮(iNO)對胎糞吸入綜閤徵(MAS)患兒機體氧化-抗氧化平衡的影響.方法 將我院新生兒科病房的55例MAS患兒隨機分為機械通氣+iNO組(A組,n=25)、機械通氣組(B組,n=30),併選擇我院同期的健康足月新生兒為對照組(C組,n=30).iNO前A、B組均接受氣管插管、氣管內吸痰、機械通氣及靜脈滴註抗生素等一般治療.A組于入院後1～2 h給予iNO治療,分彆在0、24、72 h鑑測各組患兒靜脈血血清中超氧化物歧化酶(SOD)、丙二醛(MDA)、總抗氧化能力(T-AOC)水平.結果 三組患兒一般情況比較差異無顯著性.隨著NO吸入.A組SOD、T-AOC漸增高,MDA含量降低(P＜0.05).B組SOD在24 h降低,而在72 h呈增高改變,MDA含量變化與之相反,T-AOC呈漸增高改變(P＜0.05).A組機械通氣時間及氧暴露時間分彆為(77.38±13.97)h與(158.70±47.23)h,明顯低于B組[(104.27±10.53)h與(202.15±61.92)h],差異有顯著性(P＜0.05),但兩組患兒病死率及氣漏、肺齣血、顱內齣血(Ⅱ～Ⅳ級)的髮生率差異無顯著性(P＞0.05).結論 iNO可減少機械通氣及氧暴露時間.MAS患兒體內存在不同程度的氧化-抗氧化失衡,iNO多顯示抗氧化活性,有助于機體氧化-抗氧化平衡的調節,對機體具有保護性作用.
목적 탐토흡입저농도일양화담(iNO)대태분흡입종합정(MAS)환인궤체양화-항양화평형적영향.방법 장아원신생인과병방적55례MAS환인수궤분위궤계통기+iNO조(A조,n=25)、궤계통기조(B조,n=30),병선택아원동기적건강족월신생인위대조조(C조,n=30).iNO전A、B조균접수기관삽관、기관내흡담、궤계통기급정맥적주항생소등일반치료.A조우입원후1～2 h급여iNO치료,분별재0、24、72 h감측각조환인정맥혈혈청중초양화물기화매(SOD)、병이철(MDA)、총항양화능력(T-AOC)수평.결과 삼조환인일반정황비교차이무현저성.수착NO흡입.A조SOD、T-AOC점증고,MDA함량강저(P＜0.05).B조SOD재24 h강저,이재72 h정증고개변,MDA함량변화여지상반,T-AOC정점증고개변(P＜0.05).A조궤계통기시간급양폭로시간분별위(77.38±13.97)h여(158.70±47.23)h,명현저우B조[(104.27±10.53)h여(202.15±61.92)h],차이유현저성(P＜0.05),단량조환인병사솔급기루、폐출혈、로내출혈(Ⅱ～Ⅳ급)적발생솔차이무현저성(P＞0.05).결론 iNO가감소궤계통기급양폭로시간.MAS환인체내존재불동정도적양화-항양화실형,iNO다현시항양화활성,유조우궤체양화-항양화평형적조절,대궤체구유보호성작용.
Objective To assess the effect of inhaled nitric oxide(iNO)on the balance of oxidant-antioxidant of newborns with meconium aspiration syndrome(MAS).Methods There were 55 newborns with MAS who were enrolled in neonatology department of Hebei Province Children Hospital from Febmary 2005 to April 2007.Of the total,25 newborns(group A)were treated with iNO,and the others(grotlP B)were given with conventional mechanical ventilation,witbout iNO.We also selected 30 healthy newborns of our hospital as control group(group C).Both group A and B were given with general treatment,such as tracheal intubation,irrigation of trachea,mechanical ventilation and antibiotics,et al.Group A was given iNO when their legal guardian consented after they had been in hospital for 1-2 hour.And then,we detected the serum level of SOD,MDA and T-AOC of three groups at 0,24 and 72 hour.Results There were significant differences in SOD,MDA and T-AOC among different time points(P＜0.05).With the NO inhaled,the level of SOD,TAOC in group A increased,but the MDA decreased(P＜0.05).The level of SOD in group B decreased early and increased later,while the change of MDA was opposite to it.The level of T-AOC increased as time passed (P＜0.05).Compared with group B,the ventilation time and oxygen exposure time of group A were shoner [(77.38±13.97)h vs(104.27±10.53)h,(158.70±47.23)h vs(202.15±61.92)h](P＜0.05),whereas mortality and incidence of IVH were not significantly different between the two groups.Conclusion The newborns with MAS have an imbalance between oxidant and antioxidant to some extent.Low-dose of iNO shows antioxidant property.It is benefit for the modulation of oxidant and antioxidant balance,and has an antioxidant protection to the body.
