CAJ | 학술논문

目的：测定呼吸机依赖患者痰液中肺表面活性物质相关蛋白-A（SP-A）的表达，研究SP-A与氧合指数及动脉血氧分压水平的变化。方法将机械通气患者分为呼吸机依赖组（A组）和顺利脱机组（B组），收集患者上呼吸机不同阶段上机当天及上机后2、7 d的痰液标本，应用ELISA检测两组患者痰液上清液中SP-A水平和相应时段的动脉氧分压。结果上机当天A组SP-A水平、氧合指数、动脉氧分压低于B组（P＜0．05）；A组上机2 d痰液中SP-A水平低于上机当天，上机7 d低于上机2 d ，差异有统计学意义（P＜0．05）；A组上机2d氧合指数及氧分压高于上机当天（P＜0．05），上机后7d氧合指数、氧分压与上机后2d比较差异无统计学意义（P＞0．05）。结论通过检测痰液中SP-A水平可早期判断呼吸机依赖或呼吸机相关性肺损伤的发生，可提供新的治疗途径及思路。
목적：측정호흡궤의뢰환자담액중폐표면활성물질상관단백-A（SP-A）적표체，연구SP-A여양합지수급동맥혈양분압수평적변화。방법장궤계통기환자분위호흡궤의뢰조（A조）화순리탈궤조（B조），수집환자상호흡궤불동계단상궤당천급상궤후2、7 d적담액표본，응용ELISA검측량조환자담액상청액중SP-A수평화상응시단적동맥양분압。결과상궤당천A조SP-A수평、양합지수、동맥양분압저우B조（P＜0．05）；A조상궤2 d담액중SP-A수평저우상궤당천，상궤7 d저우상궤2 d ，차이유통계학의의（P＜0．05）；A조상궤2d양합지수급양분압고우상궤당천（P＜0．05），상궤후7d양합지수、양분압여상궤후2d비교차이무통계학의의（P＞0．05）。결론통과검측담액중SP-A수평가조기판단호흡궤의뢰혹호흡궤상관성폐손상적발생，가제공신적치료도경급사로。
Objective To explore the expression of SP-A in surface active substance of sputum pulmonary of dysfunctional venti-latory weaning response patients and to study changes of expression of SP-A and oxygenation index ,arterial partial pressure of oxy-gen .Methods The mechanical ventilatory patients were divide into dysfunctional ventilatory weaning response group (group A) and easily weaning group(group B) ,then collected sputum from ventilators at different times :on the first day ,two and seven days after using ventilators .Used ELISA to test level of SP-A and oxygenation index ,arterial partial pressure of oxygen in sputum of group A and group B .Results For group A ,SP-A content oxygenation index and arterial partial pressure of oxygen were significantly less than those for group B(P<0 .05);after two days ,for group A ,SP-A content in sputum was significantly less than that on the first day ,and SP-A content in sputum was significantly less than that on the second day (P<0 .05);two days later ,oxygenation index and arterial partial pressure of oxygen were significantly lmore than those on the first day (P<0 .05) and there was no statistical difference in oxygenation index and arterial partial pressure of oxygen between the seventh day and the second day (P>0 .05) .Con-clusion Dysfunctional ventilatory weaning response and lung injury related to ventilator can be diagnosed early through the test of SP-A content in sputum ,which provides a brand-new way and method of treatment in dysfunctional ventilatory weaning response and lung injury related to ventilator .