CAJ | 학술논문

目的：测定呼吸机依赖患者痰液肺表面活性物质相关蛋白 A（SP-A）蛋白的表达，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的痰液标本：上机当天、上机后第2天、上机后第7天。应用酶联免疫吸附试验检测 A、B 两组患者痰液上清液中 SP-A 水平。并检测相应时段的动脉氧分压。结果A 组 SP-A 含量及氧合指数、动脉氧分压低于 B 组，差异有统计学意义（P ＜0．05）；A 组上机第2天痰液 SP-A 含量低于上机当天，上机后第7天 d 痰液 SP-A含量低于上机后第2天，差异均有统计学意义（P ＜0．05）；A 组上机后后第2天氧合指数及氧分压高于上机当天，差异有统计学意义（P ＜0．05），上机后第7天氧合指数、氧分压与上机后第2天相比差异无统计学意义（P ＞0．05）。结论通过检测痰液 SP-A 含量可早期判断呼吸机依赖或呼吸机相关性肺损伤的发生，为 SP-A 用于治疗呼吸机依赖或者呼吸机相关性肺损伤等提供了新的治疗途径及思路。
목적：측정호흡궤의뢰환자담액폐표면활성물질상관단백 A（SP-A）단백적표체，연구 SP-A 여양합지수급동맥혈양분압수평적변화。방법장궤계통기환자분위호흡궤의뢰조（A 조）화순리탈궤조（B 조），수집환자상호흡궤불동계단적담액표본：상궤당천、상궤후제2천、상궤후제7천。응용매련면역흡부시험검측 A、B 량조환자담액상청액중 SP-A 수평。병검측상응시단적동맥양분압。결과A 조 SP-A 함량급양합지수、동맥양분압저우 B 조，차이유통계학의의（P ＜0．05）；A 조상궤제2천담액 SP-A 함량저우상궤당천，상궤후제7천 d 담액 SP-A함량저우상궤후제2천，차이균유통계학의의（P ＜0．05）；A 조상궤후후제2천양합지수급양분압고우상궤당천，차이유통계학의의（P ＜0．05），상궤후제7천양합지수、양분압여상궤후제2천상비차이무통계학의의（P ＞0．05）。결론통과검측담액 SP-A 함량가조기판단호흡궤의뢰혹호흡궤상관성폐손상적발생，위 SP-A 용우치료호흡궤의뢰혹자호흡궤상관성폐손상등제공료신적치료도경급사로。
Objective To test expression of SP-A in surface active substance of sputum pulmonary of dysfunc-tional ventilatory weaning response patients and to study changes of expression of SP-A and oxygenation index,arte-rial partial pressure of oxygen.Methods Divide mechanical ventilatory patients into dysfunctional ventilatory wea-ning response group(group A)and easily weaning group(group B),then collected sputum from ventilators at differ-ent 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 oxy-genation index and arterial partial pressure of oxygen were less than those for group B,the two goups had statistical differences;after two days,for group A,SP-A content in sputum was less than that on the first day,and SP-A content in sputum was less than that on the second day,both had statistical differences;two days later,oxygenation index and arterial partial pressure of oxygen were more than those on the first day,had statistical differences(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.Conclusion 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.