Prophylactic treatment of very premature infants with human surfactant.
Prophylactic treatment of very premature infants with human surfactant.
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用人类表面活性剂预防性治疗极早产儿。
DOI：
10.1056/nejm198609253151301
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发表时间：
1986
期刊：
影响因子：
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通讯作者：
Pohjavuori,M
中科院分区：
文献类型：
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作者：
Merritt,TA;Hallman,M;Bloom,BT;Berry,C;Benirschke,K;Sahn,D;Key,T;Edwards,D;Jarvenpaa,AL;Pohjavuori,M
我们进行了一项随机对照试验，以确定极早产儿（胎龄24 - 29周）出生时气管内给予人表面活性剂是否能预防呼吸窘迫综合征或降低其严重程度。31例治疗组婴儿（出生体重，938±286 g）与29例对照组婴儿（出生体重，964±174 g）采用盲法进行比较。所有婴儿的卵磷脂/鞘磷脂比值小于2，出生时羊水或气管液中不存在磷脂酰甘油，表明肺部缺乏表面活性剂。主要的因变量是新生儿死亡率、支气管肺发育不良发生率和婴儿对呼吸支持的需求（及其并发症）。表面活性剂治疗组的死亡率明显低于对照组（16%对52%，P<0.001），支气管肺发育不良的病例较少（16%对31%），肺间质性肺气肿（P<0.001）和气胸（P<0.02）的病例明显减少。人表面活性剂的预防性治疗也大大减少了新生儿重症监护期。我们的结论是，人表面活性剂治疗提供了希望，以提高生存的极早产儿表面活性剂缺乏症和减少呼吸窘迫综合征的肺部后遗症。[J] .中华医学杂志1986；31(3):785 - 90。
We undertook a randomized, controlled trial to determine whether human surfactant administered endotracheally at birth to very premature infants (gestational age, 24 to 29 weeks) would prevent the respiratory distress syndrome or reduce its severity. Thirty-one treated infants (birth weight, 938±286 g) were compared in a blinded fashion with 29 control infants (birth weight, 964±174 g). The lecithin/sphingomyelin ratio was less than 2 in all infants, and phosphatidylglycerol was not present in amniotic fluid or tracheal fluids at birth, indicating a deficiency of surfactant in the lungs. The principal dependent variables were neonatal death, the incidence of bronchopulmonary dysplasia, and the infant's requirement for respiratory support (and its complications). The surfactant-treated group had significantly fewer deaths than the control group (16 percent vs. 52 percent, P<0.001), fewer cases of bronchopulmonary dysplasia (16 percent vs. 31 percent), and significantly fewer cases of pulmonary interstitial emphysema (P<0.001) and pneumothorax (P<0.02). Prophylactic treatment with human surfactant also substantially reduced the period of neonatal intensive care.We conclude that treatment with human surfactant offers promise for improving the survival of very premature infants with a surfactant deficiency and for reducing the pulmonary sequelae of the respiratory distress syndrome. (N Engl J Med 1986; 315:785–90.)