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目的探讨布地奈德(BUD)联合肺表面活性物质(PS)气管内滴入对机械通气的极低出生体质量儿肺部炎症因子的影响。方法早产儿60例,胎龄<34周,出生体重<1500g,生后4h内发生新生儿呼吸窘迫综合征(RDS),实施机械通气。随机分为两组,每组30例。PS+BUD组用PS 70mg/kg+BUD 0.25mg/kg;PS组单用PS 70mg/kg;生后30-60min内气管内滴入。第1、3、5、7、10天测定肺泡灌洗液IL-1β、TNF-α、IL-6和IL-10。结果用药第5、7、10天,PS+BUD组的IL-1β、IL-6和TNF-α明显低于PS组(P<0.05),IL-10明显高于PS组(P<0.05)。结论联合应用BUD和PS可使机械通气RDS患儿肺部促炎因子表达下调,而抑炎因子上调。
Objective To investigate the effect of intratracheal instillation of budesonide (BUD) combined with pulmonary surfactant (PS) on pulmonary inflammatory factors in mechanically ventilated very low birth weight infants. Methods 60 cases of premature children, gestational age <34 weeks, birth weight <1500g, neonatal respiratory distress syndrome (RDS) within 4h after birth, the implementation of mechanical ventilation. Randomly divided into two groups, 30 cases in each group. PS + BUD group with PS 70mg / kg + BUD 0.25mg / kg; PS group with PS 70mg / kg; within 30-60min after birth endotracheal instillation. The bronchoalveolar lavage fluid IL-1β, TNF-α, IL-6 and IL-10 were measured on the 1st, 3rd, 5th, 7th and 10th days. Results The levels of IL-1β, IL-6 and TNF-α in PS + BUD group were significantly lower than those in PS group on the 5th, 7th and 10th days (P <0.05) . Conclusions The combination of BUD and PS can reduce the expression of proinflammatory cytokines and up-regulate the proinflammatory cytokines in lungs of mechanically ventilated RDS children.