中华妇幼临床医学杂志（电子版）
中華婦幼臨床醫學雜誌（電子版）
중화부유림상의학잡지（전자판）
CHINESE JOURNAL OF OBSTETRICS & GYNECOLOGY AND PEDIATRICS(ELECTRONIC VERSION)
2014年
2期
185-188
,共4页
武荣%郑国方%朱红利%胡金绘%查丽%吕艳关%封志纯
武榮%鄭國方%硃紅利%鬍金繪%查麗%呂豔關%封誌純
무영%정국방%주홍리%호금회%사려%려염관%봉지순
肿瘤坏死因子-alpha%白细胞介素-8%血管内皮生长因子%交互式通气支持%胎粪吸入综合征%婴儿,新生
腫瘤壞死因子-alpha%白細胞介素-8%血管內皮生長因子%交互式通氣支持%胎糞吸入綜閤徵%嬰兒,新生
종류배사인자-alpha%백세포개소-8%혈관내피생장인자%교호식통기지지%태분흡입종합정%영인,신생
Tumor necrosis factor-alpha%Interleukin-8%Vascular endothelial growth factor%Interactive ventilatory support%Meconium aspiration syndrome%Infant,newborn
目的：探讨比例辅助通气(PAV)对新生儿胎粪吸入综合征(MAS)患儿血浆中肿瘤坏死因子(TNF)-α、白细胞介素(IL)-8和血管内皮生长因子(VEGF)水平的影响。方法选择2011年1月至2013年10月在扬州大学医学院附属淮安市妇幼保健院住院治疗的30例新生儿 MAS患儿为研究对象,按照随机数字表法,将其分为PAV组(n=15,给予PAV模式支持)和同步间隙指令通气(SIMV)组(n=15,给予SIMV模式支持)。随机选取同期在本院产科出生的10例健康足月新生儿纳入对照组。3组患儿的性别、胎龄、出生体质量等一般临床资料比较,差异无统计学意义(P>0.05)。采用酶联免疫吸附测定法测定各组新生儿生后1 d和3 d时血浆 TNF-α、IL-8和 VEGF的水平(本研究遵循的程序符合扬州大学医学院附属淮安市妇幼保健院伦理委员会制定的伦理学标准,得到该委员会批准,分组征得受试对象监护人的知情同意,并与之签署临床研究知情同意书)。结果3组血浆 TNF-α水平在生后1 d、3 d 比较[(1395.80±426.46)ng/L vs.(1428.27±414.24)ng/L vs.(374.30±229.91)ng/L；(1356.87±315.54)ng/L vs.(1602.13±371.10)ng/L vs.(383.30±187.00))ng/L],差异均有统计学意义(F=27.573,48.142,P=0.000)；IL-8水平在生后1 d、3 d 比较[(2.231±1.063)μg/L vs.(2.409±1.058)μg/L vs.(0.398±0.214)μg/L；(1.813±0.701)μg/L vs.(2.484±1.049)μg/L vs.(0.409±0.231)μg/L],差异均有统计学意义(F=216.198,21.173,P=0.000),VEGF 水平于生后1 d、3 d 比较[(167.07±77.23)ng/L vs.(179.93±78.83)ng/L vs.(41.90±13.51)ng/L；(141.73±52.69)ng/L vs.(186.27±68.25)ng/L vs.(39.10±10.14)ng/L],差异亦有统计学意义(F=14.092,22.987,P=0.000)。结论在维持正常血氧饱和度和血气值的情况下,PAV模式所致肺损伤程度较 SIMV模式小。
目的：探討比例輔助通氣(PAV)對新生兒胎糞吸入綜閤徵(MAS)患兒血漿中腫瘤壞死因子(TNF)-α、白細胞介素(IL)-8和血管內皮生長因子(VEGF)水平的影響。方法選擇2011年1月至2013年10月在颺州大學醫學院附屬淮安市婦幼保健院住院治療的30例新生兒 MAS患兒為研究對象,按照隨機數字錶法,將其分為PAV組(n=15,給予PAV模式支持)和同步間隙指令通氣(SIMV)組(n=15,給予SIMV模式支持)。隨機選取同期在本院產科齣生的10例健康足月新生兒納入對照組。3組患兒的性彆、胎齡、齣生體質量等一般臨床資料比較,差異無統計學意義(P>0.05)。採用酶聯免疫吸附測定法測定各組新生兒生後1 d和3 d時血漿 TNF-α、IL-8和 VEGF的水平(本研究遵循的程序符閤颺州大學醫學院附屬淮安市婦幼保健院倫理委員會製定的倫理學標準,得到該委員會批準,分組徵得受試對象鑑護人的知情同意,併與之籤署臨床研究知情同意書)。結果3組血漿 TNF-α水平在生後1 d、3 d 比較[(1395.80±426.46)ng/L vs.(1428.27±414.24)ng/L vs.(374.30±229.91)ng/L；(1356.87±315.54)ng/L vs.(1602.13±371.10)ng/L vs.(383.30±187.00))ng/L],差異均有統計學意義(F=27.573,48.142,P=0.000)；IL-8水平在生後1 d、3 d 比較[(2.231±1.063)μg/L vs.(2.409±1.058)μg/L vs.(0.398±0.214)μg/L；(1.813±0.701)μg/L vs.(2.484±1.049)μg/L vs.(0.409±0.231)μg/L],差異均有統計學意義(F=216.198,21.173,P=0.000),VEGF 水平于生後1 d、3 d 比較[(167.07±77.23)ng/L vs.(179.93±78.83)ng/L vs.(41.90±13.51)ng/L；(141.73±52.69)ng/L vs.(186.27±68.25)ng/L vs.(39.10±10.14)ng/L],差異亦有統計學意義(F=14.092,22.987,P=0.000)。結論在維持正常血氧飽和度和血氣值的情況下,PAV模式所緻肺損傷程度較 SIMV模式小。
목적：탐토비례보조통기(PAV)대신생인태분흡입종합정(MAS)환인혈장중종류배사인자(TNF)-α、백세포개소(IL)-8화혈관내피생장인자(VEGF)수평적영향。방법선택2011년1월지2013년10월재양주대학의학원부속회안시부유보건원주원치료적30례신생인 MAS환인위연구대상,안조수궤수자표법,장기분위PAV조(n=15,급여PAV모식지지)화동보간극지령통기(SIMV)조(n=15,급여SIMV모식지지)。수궤선취동기재본원산과출생적10례건강족월신생인납입대조조。3조환인적성별、태령、출생체질량등일반림상자료비교,차이무통계학의의(P>0.05)。채용매련면역흡부측정법측정각조신생인생후1 d화3 d시혈장 TNF-α、IL-8화 VEGF적수평(본연구준순적정서부합양주대학의학원부속회안시부유보건원윤리위원회제정적윤리학표준,득도해위원회비준,분조정득수시대상감호인적지정동의,병여지첨서림상연구지정동의서)。결과3조혈장 TNF-α수평재생후1 d、3 d 비교[(1395.80±426.46)ng/L vs.(1428.27±414.24)ng/L vs.(374.30±229.91)ng/L；(1356.87±315.54)ng/L vs.(1602.13±371.10)ng/L vs.(383.30±187.00))ng/L],차이균유통계학의의(F=27.573,48.142,P=0.000)；IL-8수평재생후1 d、3 d 비교[(2.231±1.063)μg/L vs.(2.409±1.058)μg/L vs.(0.398±0.214)μg/L；(1.813±0.701)μg/L vs.(2.484±1.049)μg/L vs.(0.409±0.231)μg/L],차이균유통계학의의(F=216.198,21.173,P=0.000),VEGF 수평우생후1 d、3 d 비교[(167.07±77.23)ng/L vs.(179.93±78.83)ng/L vs.(41.90±13.51)ng/L；(141.73±52.69)ng/L vs.(186.27±68.25)ng/L vs.(39.10±10.14)ng/L],차이역유통계학의의(F=14.092,22.987,P=0.000)。결론재유지정상혈양포화도화혈기치적정황하,PAV모식소치폐손상정도교 SIMV모식소。
Objective To investigate influences of tumor necrosis factor-α(TNF-α),interleukin-8(IL-8)and vascular endothelial growth factor(VEGF)of neonates with meconium aspiration syndrome(MAS) treated by proportional assist ventilation (PAV).Methods From January 2011 to October 2013,a total of 30 neonates with MAS who required mechanical ventilation were recruited into this study.They were divided randomly into two groups according to different ventilation modes PAV group(n=1 5 ,supported by PAV mode)and synchronized intermittent mandatory ventilation (SIMV)group (n=15,supported by SIMV mode).There had no significant differences between two groups on age,gestation age,birth weight, and so on (P>0.05).At the same time,another 10 healthy term infants were selected as control group. The plasma TNF-α,IL-8 and VEGF levels of neonates in three groups were measured by enzyme linked immunosorbent assay at the first day and third day after birth.The study protocol was approved by the Ethical Review Board of Investigation in Huaian Maternity and Child Healthcare Hospital Affiliated to Yangzhou University Medical Academy.Informed consent was obtained from all participates′parents. Results There had no statistically significant differences of TNF-αlevels among three groups at first day and third day [(1 395.80±426.46)ng/L vs.(1 428.27±414.24)ng/L vs.(374.30±229.91)ng/L;(1 356.87±315.54)ng/L vs.(1 602.13±371.10)ng/L vs.(383.30±187.00)ng/L;F=27.573, 48.142,P=0.000],there also had statistically significant differences of IL-8 levels among three groups at first day and third day [(2.231±1.063)μg/L vs.(2.409±1.058)μg/L vs.(0.398±0.214)μg/L;(1.813±0.701)μg/L vs.(2.484±1.049)μg/L vs.(0.409±0.231)μg/L;F=216.198,21.173,P=0.000],and there had no statistically significant differences of VEGF levels among three groups at first day and third day [(167.07±77.23)ng/L vs.(179.93±78.83)ng/L vs.(41.90±13.51)ng/L;(141.73± 52.69)ng/L vs.(186.27±68.25)ng/L vs.(39.10±10.14)ng/L;F=14.092,22.987,P=0.000]. Conclusions In case to maintain normal oxygen saturation and blood gas,PAV mode can reduce the incidence rate of ventilation-induced lung inj ury than that of SIMV mode.
