无创呼吸支持模式对早产儿支气管肺发育不良及相关生物学指标的影响
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摘要
目的分析无创呼吸支持模式对早产儿支气管肺发育不良(BPD)及相关生物学指标的影响。方法 56例需呼吸支持的早产儿,根据患儿无创呼吸支持模式的不同分为NIPPV组及NCPAP组,每组28例。NIPPV组开展经鼻间歇正压通气(NIPPV), NCPAP组开展经鼻持续正压通气(NCPAP)。比较两组患儿BPD发病情况及相关生物学指标变化情况。结果 NIPPV组患儿BPD发病率为3.57%,低于NCPAP组的10.71%,但差异无统计学意义(P>0.05);生后第1天,两组患儿血白细胞介素-6(IL-6)、白细胞介素-10(IL-10)、肿瘤坏死因子-α(TNF-α)水平比较,差异无统计学意义(P>0.05)。生后第3天, NIPPV组患儿血IL-6(211.37±206.38)pg/ml、IL-10(1890.48±1840.10)pg/ml高于NCPAP组患儿的(7.34±7.19)、(59.73±34.80)pg/ml,差异具有统计学意义(P<0.05);两组患儿TNF-α水平比较差异无统计学意义(P>0.05)。结论 NIPPV较NCPAP可能更利于减少BPD的发生不能被证实,但NIPPV较NCPAP更能上调血炎症介质水平。
Objective To analyze the effect of non-invasive respiratory support model on bronchopulmonary dysplasia(BPD) and related biological indicators in premature infants. Methods A total of 56 premature infants requiring respiratory support were divided by different non-invasive respiratory support models into NIPPV group and NCPAP group, with 28 cases in each group. NIPPV group received nasal intermittent positive airway pressure(NIPPV), and NCPAP group received nasal continuous positive airway pressure(NCPAP). The incidence of BPD and the changes of related biological indicators were compared between the two groups. Results NIPPV group had lower incidence of BPD as 3.57% than 10.71% in NCPAP group, but the difference was not statistically significant(P>0.05). At 1 day after birth, both groups had no statistically significant difference in interleukin-6(IL-6), interleukin-10(IL-10), tumor necrosis factor-α(TNF-α) levels(P>0.05). At 3 day after birth, NIPPV group had higher IL-6 as(211.37±206.38) pg/ml, IL-10 as(1890.48±1840.10) pg/ml than(7.34±7.19) and(59.73±34.80) pg/ml in NCPAP group. Their difference was statistically significant(P<0.05). Both groups had no statistically significant difference in TNF-α level(P>0.05). Conclusion NIPPV may be more conducive to reducing the occurrence of BPD than NCPAP, but NIPPV is more able to upregulate blood inflammatory mediators than NCPAP.
Objective To analyze the effect of non-invasive respiratory support model on bronchopulmonary dysplasia(BPD) and related biological indicators in premature infants. Methods A total of 56 premature infants requiring respiratory support were divided by different non-invasive respiratory support models into NIPPV group and NCPAP group, with 28 cases in each group. NIPPV group received nasal intermittent positive airway pressure(NIPPV), and NCPAP group received nasal continuous positive airway pressure(NCPAP). The incidence of BPD and the changes of related biological indicators were compared between the two groups. Results NIPPV group had lower incidence of BPD as 3.57% than 10.71% in NCPAP group, but the difference was not statistically significant(P>0.05). At 1 day after birth, both groups had no statistically significant difference in interleukin-6(IL-6), interleukin-10(IL-10), tumor necrosis factor-α(TNF-α) levels(P>0.05). At 3 day after birth, NIPPV group had higher IL-6 as(211.37±206.38) pg/ml, IL-10 as(1890.48±1840.10) pg/ml than(7.34±7.19) and(59.73±34.80) pg/ml in NCPAP group. Their difference was statistically significant(P<0.05). Both groups had no statistically significant difference in TNF-α level(P>0.05). Conclusion NIPPV may be more conducive to reducing the occurrence of BPD than NCPAP, but NIPPV is more able to upregulate blood inflammatory mediators than NCPAP.
引文
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[2]唐仕芳,赵锦宁,沈洁.经鼻间歇和持续气道正压通气治疗新生儿呼吸窘迫综合征的Meta分析.中国循证儿科杂志, 2011,6(4):255-263.
[3]Li W, Long C, Zhangxue H, et al. Nasal intermittent positive pressure ventilation versus nasal continuous positive airway pressure for preterm infants with respiratory distress syndrome:A metaanalysis and up-date. Pediatr Pulmonol, 2015, 50(4):402-409.
[4]韩明珊,谢辰仪,黄花荣,等.支气管肺发育不良早产儿呼吸系统疾病预后的研究进展.中华妇幼临床医学杂志(电子版),2016, 12(5):617-620.
[5]陈佳,高薇薇,聂川,等.经鼻间歇与鼻塞式持续正压通气治疗早产低出生体重儿呼吸窘迫综合征.中华围产医学杂志,2015, 18(2):111-116.
[6]杨建生,吴本清,贺务实,等.经鼻间歇正压通气治疗早产儿呼吸窘迫综合征疗效观察.中国新生儿科杂志, 2011,26(5):315-318.
[7]Nilgün K?ksal. Value of serum and bronchoalveolar fluid lavage pro-and anti-inflammatory cytokine levels for predicting bronchopulmonary dysplasia in premature infants. European Cytokine Network, 2012, 23(2):29-35.
[8]黄进洁,吴本清,丁璐.过度通气致新生鼠肺损伤炎症机制的研究.中国现代医学杂志, 2010, 20(10):1446-1449.
[2]唐仕芳,赵锦宁,沈洁.经鼻间歇和持续气道正压通气治疗新生儿呼吸窘迫综合征的Meta分析.中国循证儿科杂志, 2011,6(4):255-263.
[3]Li W, Long C, Zhangxue H, et al. Nasal intermittent positive pressure ventilation versus nasal continuous positive airway pressure for preterm infants with respiratory distress syndrome:A metaanalysis and up-date. Pediatr Pulmonol, 2015, 50(4):402-409.
[4]韩明珊,谢辰仪,黄花荣,等.支气管肺发育不良早产儿呼吸系统疾病预后的研究进展.中华妇幼临床医学杂志(电子版),2016, 12(5):617-620.
[5]陈佳,高薇薇,聂川,等.经鼻间歇与鼻塞式持续正压通气治疗早产低出生体重儿呼吸窘迫综合征.中华围产医学杂志,2015, 18(2):111-116.
[6]杨建生,吴本清,贺务实,等.经鼻间歇正压通气治疗早产儿呼吸窘迫综合征疗效观察.中国新生儿科杂志, 2011,26(5):315-318.
[7]Nilgün K?ksal. Value of serum and bronchoalveolar fluid lavage pro-and anti-inflammatory cytokine levels for predicting bronchopulmonary dysplasia in premature infants. European Cytokine Network, 2012, 23(2):29-35.
[8]黄进洁,吴本清,丁璐.过度通气致新生鼠肺损伤炎症机制的研究.中国现代医学杂志, 2010, 20(10):1446-1449.