A controlled trial of human surfactant replacement therapy for severe respiratory distress syndrome in very low birth weight infants.
A controlled trial of human surfactant replacement therapy for severe respiratory distress syndrome in very low birth weight infants.
复制标题
人类表面活性剂替代疗法治疗极低出生体重婴儿严重呼吸窘迫综合征的对照试验。
DOI：
10.1016/s0022-3476(05)82897-5
复制
发表时间：
1990
期刊：
影响因子：
--
通讯作者：
T. Merritt
中科院分区：
文献类型：
--
作者：
Michael J. Lang;Michael J. Lang;Michael J. Lang;R. Hall;R. Hall;R. Hall;N. S. Reddy;Nallu S. Reddy;Nallu S. Reddy;T. Merritt;T. Merritt;T. Merritt
在一项随机、对照研究中，对妊娠24 - 32周出生的重度呼吸窘迫综合征婴儿（体重≤1500 gm）在出生后12小时内给予羊水来源的人表面活性剂。如果治疗组患者符合呼吸机要求，表明复发或对初始剂量无反应，则给予第二剂表面活性剂。与对照组相比，经表面活性剂治疗的婴儿在死亡率（9/28 vs 15/31）或支气管肺发育不良发生率（5/28 vs 3/31）方面未观察到显著改善，尽管初始呼吸机和吸入氧需求显著降低，动脉/肺泡氧比改善。此外，治疗婴儿的肺漏气显著减少（10/28 vs 20/31;p<0.05）。再治疗与减毒反应相关，死亡率（7/14）高于不需要第二次给药的婴儿（2/14;p=0.05），表明疾病形式更严重。多元判别分析，包括8个独立变量，显示出生体重增加，年龄较早的表面活性剂治疗，女性与生存率显着相关。这些数据表明，早期表面活性剂治疗可以降低极低出生体重儿严重呼吸窘迫综合征的死亡率，以及减少呼吸机的需求和肺漏气的发生率。
In a randomized, controlled study, human surfactant derived from amniotic fluid was administered within 12 hours of birth to infants with severe respiratory distress syndrome who were born at 24 to 32 weeks of gestation weighing ≤1500 gm. A second dose of surfactant was given to patients in the treatment group if they met ventilator requirements indicating relapse or lack of response to the initial dose. No significant improvement was observed in mortality rate (9/28 vs 15/31) or incidence of bronchopulmonary dysplasia (5/28 vs 3/31) when surfactant-treated infants were compared with control subjects, although there was a significant reduction in initial respirator and inspired oxygen requirements and the arterial/alveolar oxygen ratio improved. In addition, there was a significant reduction in pulmonary air leak in treated infants (10/28 vs 20/31;p<0.05). Retreatment was associated with an attenuated ventilatory response and with a higher mortality rate (7/14) than that of infants who did not require a second dose (2/14;p=0.05), indicating a more severe form of disease. Multiple discriminant analysis, including eight independent variables, revealed that increasing birth weight, earlier age at surfactant treatment, and female gender were significantly associated with survival. These data suggest that early surfactant treatment may reduce mortality rates in very low birth weight infants with severe respiratory distress syndrome, as well as reduce ventilator requirements and the incidence of pulmonary air leaks.
从羊水中分离人表面活性剂及其对呼吸窘迫综合征功效的初步研究。
影响因子：
8
作者：
Hallman,M;Merritt,TA;Schneider,H;Epstein,BL;Mannino,F;Edwards,DK;Gluck,L
通讯作者：
Gluck,L