摘要
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1d和3d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1d、3d比较[(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],差异均有统计学意义(F=27.573,48.142,P=0.000);IL-8水平在生后1d、3d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1d、3d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/Lvs.(186.27±68.25)ng/Lvs.(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。
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.＆amp;nbsp;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.
出处
《中华妇幼临床医学杂志（电子版）》
CAS
2014年第2期55-58,共4页
Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition)
基金
江苏省卫生厅科研项目(F201233)~~
作者简介
通信作者：封志纯，Email：zhjfengzc@126．com
