Surfactant protein A in gastric fluid at birth as a useful marker of differentiation diagnosis between respiratory distress syndrome and transient tachypnea of the newborn
Surfactant protein A in gastric fluid at birth as a useful marker of differentiation diagnosis between respiratory distress syndrome and transient tachypnea of the newborn
复制标题
出生时胃液中的表面活性蛋白A作为新生儿呼吸窘迫综合征和短暂性呼吸急促鉴别诊断的有用标志物
DOI：
10.1111/j.1442-200x.2011.03440.x
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发表时间：
2011
期刊：
影响因子：
1.4
通讯作者：
Ikeda K
中科院分区：
文献类型：
--
作者：
Matsuzaki Y;Hokuto I;Ikeda K
在妊娠30周后出生的早产儿中，根据胸部X线和临床表现，很难将呼吸窘迫综合征（RDS）与其他呼吸系统疾病（如新生儿短暂性呼吸急促（TTN））区分开来。表面活性蛋白A（SP-A）在肺泡II型细胞中合成。已知通过测量羊水中SP-A浓度可以估计胎儿肺的成熟度。1、2然而，出生时收集羊水是困难的。作为出生时胎儿肺成熟度的指标，微泡试验在日本被普遍采用。3虽然一些研究调查了出生时胃液而不是羊水中的SP-A浓度，4-7没有英文出版物，并且由于数据有限，截止值各不相同。在本研究中，我们对我院出生的179名新生儿进行了大规模回顾性分析，以检查胃液SP-A浓度与临床症状之间的相关性。我们回顾了2005年11月至2010年10月在庆应义塾大学医院新生儿重症监护室（NICU）出生的206例正常/早产新生儿RDS胃液中SP-A的截止浓度。出生后立即用胃管收集这些新生儿的胃液，采用酶免疫测定法（Sysmex Corporation，Hyogo，Japan）测定SP-A浓度。根据临床症状将受试者分为两组：RDS组和非RDS组。使用Mann-Whitney U检验进行统计分析。我们回顾了179名新生儿，排除了4名胎粪吸入综合征和23名无法收集胃液的新生儿（RDS组，7名;非RDS组，16名）。179名新生儿中有66名临床诊断为RDS，113名为非RDS疾病。RDS组与非RDS组的出生体重、胎龄差异有统计学意义。性别、产前类固醇治疗或剖宫产率无差异（表1）。RDS组和非RDS组胃液中SP-A浓度中位数分别为310和1870 ng/mL。那里
In premature babies born after 30 weeks’ gestation, it is hard to differentiate respiratory distress syndrome (RDS) from other respiratory disorders, such as transient tachypnea of the newborn (TTN), based on chest X-ray and clinical findings. Surfactant protein A (SP-A) is synthesized in alveolar type II cells. It is known that the maturity of the fetal lung can be estimated by measuring SP-A concentration in amniotic fluid. 1, 2 However, amniotic fluid collection at birth is difficult. As an index of the maturity of the fetal lung at birth, the microbubble test is commonly employed in Japan. 3 While some studies have investigated the SP-A concentration in gastric fluid instead of amniotic fluid at birth, 4–7 there is no publication written in English, and cut-off values vary due to limited data. In this study, we performed a large-scale, retrospective analysis to examine the association between the gastric fluid concentration of SP-A and clinical symptoms in 179 neonates born in our hospital. We reviewed the cut-off concentration of SP-A in the gastric fluid of neonates with RDS.The subjects were 206 normal-/premature-birth neonates born in the neonatal intensive care unit (NICU) of Keio University Hospital from November 2005 to October 2010. Immediately after birth, gastric fluid was collected from these neonates using a gastric tube to measure the concentration of SP-A employing an enzyme immunoassay (Sysmex Corporation, Hyogo, Japan). The subjects were divided into two groups by their clinical symptoms: the RDS and non-RDS groups. Statistical analysis was performed using the Mann–Whitney U-test. We reviewed 179 neonates, excluding four with meconium aspiration syndrome and 23 in whom gastric fluid collection was impossible (RDS group, seven; non-RDS group, 16). Sixty-six of the 179 neonates were diagnosed with RDS clinically, and 113 with non-RDS disorders. There were significant differences in the birthweight and gestational age between the RDS and non-RDS groups. There were no differences in the sex, prenatal steroid therapy, or cesarean section rate (Table 1). The median concentrations of SP-A of gastric fluid in the RDS and non-RDS groups were 310 and 1870 ng/mL, respectively. There