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| 新生儿呼吸窘迫综合征经肺表面活性物质联合布地奈德治疗后对
6 岁时肺功能影响的队列研究 |
| 时春明,杨波,赵丹丹,任漪,王乐瑶,孙中怡,蒋红侠 |
|
|
| ((徐州市中心医院,徐州医科大学徐州临床学院,江苏徐州
221009)) |
|
| 摘要: |
| 目的:比较新生儿呼吸窘迫综合征(NRDS)早期气管内滴注肺表面活性物质(PS) 或联合布地奈德治疗后对患儿6 岁时
肺功能的影响,了解远期预后。方法:收集2016-2019 年参与本团队开展的气管内注入PS 或联合布地奈德治疗NRDS 早产儿
的前瞻性随机对照研究的病例资料及其6 岁时肺功能资料,分为单独使用PS 组(PS 组) 和PS 联合布地奈德组(PSB 组)。结
果:PSB 组6 岁时用力呼气过程中呼出肺活量从25%至75%阶段的平均呼气流量( FEF25-75 ) / 预测值、FEF50 / 预测值均大于PS
组(P<0. 05);PSB 组FEF25-75 / 预测值<0. 8 患儿数、FEF50 / 预测值<0. 8 患儿数均少于PS 组(P<0. 05)。PSB 组2 岁内因呼吸道
感染就诊和住院次数少于PS 组(P<0. 05)。两组患儿第1 秒用力呼气容积/ 用力肺活量值、第1 秒用力呼气容积/ 用力肺活量
值<0. 8 患儿数及远期临床结局比较差异无统计学意义(P>0. 05)。结论:NRDS 患儿6 岁时易发生小气道功能障碍。与单用
PS 相比,PS 联合布地奈德早期气管内滴注可能改善NRDS 患儿远期肺功能,且未增加糖皮质激素远期不良结局。 |
| 关键词: 布地奈德 呼吸窘迫综合征 肺功能 |
| DOI：doi:10.13407/j.cnki.jpp.1672-108X.2025.10.002 |
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| 基金项目:徐州市科技局重点研发计划,编号KC22170 |
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| A Cohort Study on Effects of Pulmonary Surfactant Combined with Budesonide in the Treatment ofNeonatal Respiratory Distress Syndrome on Pulmonary Function at 6 Years Old |
| Shi Chunming, Yang Bo, Zhao Dandan, Ren Yi, Wang Leyao, Sun Zhongyi, Jiang Hongxia |
| ((Xuzhou Central Hospital,
Xuzhou Clinical College of Xuzhou Medical University, Jiangsu Xuzhou 221009, China)) |
| Abstract: |
| Objective: To compare the pulmonary function at 6 years old after early intratracheal instillation of pulmonary surfactant
(PS) alone or in combination with budesonide in neonates with neonatal respiratory distress syndrome (NRDS), and to investigate the
long-term prognosis. Methods: The case data and pulmonary function data at 6 years old were collected from preterm infants with NRDS
who participated into the prospective randomized controlled study from 2016 to 2019, in which the infants were treated with intratracheal instillation of PS alone or in combination with budesonide. These infants were divided into the PS alone group (PS group) and PS
combined with budesonide group (PSB group). Results: At 6 years old, the ratio of the forced expiratory flow between 25% and 75%
of forced vital capacity (FEF25-75 ) to the predicted value, and the ratio of FEF50 to the predicted value in the PSB group were higher than
those in the PS group (P<0. 05). The rates of FEF25-75 to the predicted value <0. 8 and FEF50 to the predicted value <0. 8 in the PSB
group were both less than those in the PS group (P<0. 05). The number of visits and hospitalizations due to respiratory tract infections
within 2 years old in the PSB group was less than that in the PS group (P<0. 05). There were no statistically significant differences in
the ratio of forced expiratory volume at 1 second to forced vital capacity, the proportion of cases with forced expiratory volume at 1 second
to forced vital capacity <0. 8, and long-term clinical outcomes between two groups (P>0. 05). Conclusion: Children with NRDS are
prone to develop small airway dysfunction at 6 years of age. Compared with intratracheal instillation of PS alone, early intratracheal
instillation of PS combined with budesonide may improve the long-term pulmonary function of children with NRDS without increasing the
long-term adverse outcomes associated with glucocorticoids. |
| Key words: budesonide respiratory distress syndrome pulmonary function |
