| 摘要: |
| 目的:观察不同剂量维生素 D(VD)联合微创注入肺表面活性物质(LISA)预防早产儿支气管肺发育不良(BPD)的效果 及对患儿炎症反应、动脉血气的影响。 方法:回顾性纳入 2023 年 5 月-2024 年 10 月我院收治的 176 例 BPD 高危早产儿临床资 料,根据 VD 剂量分为低剂量组(400 IU/ d,n = 78)和高剂量组(800 IU/ d,n = 98)。 所有早产儿均予 LISA 和 VD 口服治疗,比较 两组患儿 BPD 发生率、血气、潮气肺功能、炎症因子、25-羟基维生素 D3 、肺表面活性蛋白等指标。 结果:高剂量组 BPD 发生率、 临床指标低于低剂量组,临床指标恢复更好(P<0. 05);两组患儿动脉血氧分压(PaO2 )水平、PaO2 / 吸入氧浓度(FiO2 )升高,动 脉血二氧化碳分压(PaCO2 )水平降低,高剂量组变化更显著(P<0. 05);潮气肺功能、25-羟基维生素 D3 、表面活性蛋白( SP)-A 和 SP-B 升高,炎症因子降低,高剂量组更优(P<0. 05);两组患儿不良反应比较差异无统计学意义(P>0. 05)。 VD 剂量是 BPD 发生的独立相关因素。 结论:高剂量 VD 联合 LISA 可有效预防 BPD,改善血气、肺功能及炎症,安全性好。 |
| 关键词: 早产儿支气管肺发育不良 维生素 D 微创注入肺表面活性物质 预防 |
| DOI：10.13407/j.cnki.jpp.1672-108X.2026.06.003 |
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| 基金项目:保定市科学技术计划项目,编号 2341ZF120 |
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| A Cohort Study on Prevention of Bronchopulmonary Dysplasia in Premature Infants by Different Doses of Vitamin D Combined with Less-Invasive Surfactant Administration |
| Zhang Chen, Qie Xuemin, Tian Fanglu, Wang Jiao |
| (Baoding Maternal and Child Health Hospital, Hebei Baoding 071000, China) |
| Abstract: |
| Objective: To observe the effect of different doses of vitamin D (VD) combined with less-invasive surfactant administration (LISA) on the prevention of bronchopulmonary dysplasia (BPD) and its effects on inflammatory response and arterial blood gas in preterm infants. Methods: A total of 176 preterm infants at high risk of BPD from May 2023 to Oct. 2024 were retrospectively enrolled. According to the VD dose, all patients were divided into the low dose group (400 IU/ d, n= 78) and high dose group (800 IU/ d, n= 98). All the children were treated with LISA and oral VD. The incidence of BPD, blood gas analysis, tidal lung function, inflammatory factors, 25-hydroxyvitamin D3 , pulmonary surfactant protein and other indicators were compared. Results: The incidence of BPD and clinical indicators in high dose group were lower than those in low dose group, and the recovery of clinical indicators was better (P<0. 05). The arterial partial pressure of oxygen (PaO2 ) and PaO2 / fraction of inspired oxygen (FiO2 ) increased and arterial partial pressure of carbon dioxide (PaCO2 ) decreased in two groups, and the changes were more significant in the high dose group (P<0. 05). Tidal lung function, 25-hydroxyvitamin D3 and surface active protein (SP)-A/ SP-B increased significantly, while inflammatory factors decreased in two groups, the high dose group showed better results ( P < 0. 05). There was no statistically significant difference in adverse drug reactions (P>0. 05). VD dose was an independent risk factor for BPD. Conclusion: High dose VD combined with LISA can effectively prevent BPD and improve blood gas, lung function, and inflammation with higher safety. |
| Key words: bronchopulmonary dysplasia in premature infants vitamin D less invasive surfactant administration prevention |
