| 郑丽娜.氦氧混合气治疗新生儿胎粪吸入综合征的临床疗效及 对血浆miR-155水平的影响[J].浙江中西医结合杂志,2024,34(8): |
| 氦氧混合气治疗新生儿胎粪吸入综合征的临床疗效及 对血浆miR-155水平的影响 |
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| 投稿时间：2024-02-21 修订日期：2024-04-23 |
| DOI： |
| 中文关键词: 氦氧混合气 胎粪吸入综合征 新生儿 |
| 英文关键词:Helium oxygen mixture meconium aspiration syndrome Neonate |
| 基金项目: |
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| 摘要点击次数: 884 |
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| 中文摘要: |
| 目的? 探讨SIMV联合氦氧混合气治疗新生儿胎粪吸入综合征(MAS)的疗效及对血浆miR-155水平的影响。方法? 选择MAS患儿64例,其中男性37例,女性27例；出生时间范围0.4～0.9小时,平均出生0.59小时。随机分为观察组和对照组,各32例。患儿均给予SIMV,观察组吸入Heliox,6 h后吸入空氧混合气；对照组吸入空氧混合气。观察0、6、12、24、48 h的PO2、PCO2、SaO2、a/APO2、治疗后6 h白细胞介素6(IL-6)、C反应蛋白(CRP)、miR-155水平、上机时间、住院时间及机械通气并发症发生率。结果 ?与0 h比较,两组6、12、24、48 h时PO2、SaO2、a/APO2不同程度的升高,PCO2降低,两组间比较,差异有统计学意义(P＜0.05)。与治疗前比较,治疗后6 h观察组与对照组患儿血浆miR-155水平升高[(1.06 ± 0.04)vs(0.22 ± 0.02)、(0.41± 0.03)vs(0.23 ± 0.01)],外周血IL-6[(14.56 ± 1.67)pg/mL vs(31.12 ± 2.63)pg/mL、(21.12 ± 3.13)pg/mL vs(31.24 ± 3.31)pg/mL]及CRP[(5.35± 0.80)mg/L vs(6.08 ± 1.14)mg/L、(5.86 ± 0.91)mg/L vs(6.11± 1.24)mg/L]表达水平降低,治疗后两组间miR-155、IL-6和CRP比较差异有统计学意义[(1.06 ± 0.04)vs(0.41± 0.03)、(14.56 ± 1.67)pg/mL vs (21.12 ± 3.13)pg/mL、(5.35 ± 0.80)mg/L vs(5.86 ± 0.91)mg/L,P ＜ 0.05]。观察组上机和住院时间小于对照组[(3.14 ± 0.12)d vs(5.02 ± 0.07)d,(11.23 ± 3.53)d vs(15.27 ± 2.11)d ；P = 0.000、0.007]。观察组并发症发生率小于对照组(6.25 % vs 15.63 %,P = 0.000)。结论? SIMV支持下吸入Heliox可改善MAS患儿呼吸功能,减轻炎症反应,提高miR-155水平,缩短治疗时间,安全性好。 |
| 英文摘要: |
| Objective? To investigate the clinical effect of inhalation of helium oxygen mixture under SIMV support in the treatment of neonatal meconium aspiration syndrome(MAS) and its influence on plasma miR-155 level. Methods? 64 children with MAS in our hospital from March 2019 to March 2021 were selected. There were 37 males and 27 females; the time of birth ranged from 0.4 to 0.9 hours, with an average of 0.59 hours.They were randomly divided into the observation group and the control group, 32 cases each. They were given SIMV respiratory support mode. The observation group inhaled Heliox(70 % He, 30 % O2), 6 hours later inhaled air oxygen mixture(O2 30 %); while the control group inhaled air oxygen mixture. The blood gas analysis indexes (PO2、PCO2、SaO2、a/APO2) at 0, 6, 12, 24, 48 h after treatment were observed.The levels of interleukin-6(IL-6), C-reactive protein (CRP) and miR-155 at 6 h after treatment; the duration of mechanical ventilation and hospitalization; the incidence of complications of mechanical ventilation were observed. Results Compared with 0 h, PO2, SaO2, a/APO2 increased at 6 h, 12 h, 24 h and 48 h, and PCO2 decreased in 2 groups. There was significant difference between 2 groups(P < 0.05). After 6 h treatment, the levels of plasma miR-155 [(1.06 ± 0.04) vs (0.22 ± 0.02), (0.41± 0.03) vs (0.23 ± 0.01)] in the 2 groups were increased, and the expression levels of IL-6 [(14.56 ± 1.67) pg/mL vs (31.12 ± 2.63) pg/mL, (21.12 ± 3.13) pg/mL vs (31.24 ± 3.31) pg/mL]and CRP [(5.35± 0.80) mg/L vs (6.08 ± 1.14) mg/L, (5.86 ± 0.91) mg/L vs (6.11± 1.24) mg/L]in peripheral blood were decreased. There was significant difference between 2 groups[(1.06 ± 0.04) vs (0.41± 0.03), (14.56 ± 1.67) pg/mL vs (21.12 ± 3.13) pg/mL, (5.35 ± 0.80) mg/L vs (5.86 ± 0.91) mg/L, P ＜ 0.05].The time of mechanical ventilation and hospital stay time in the observation group were shorter than those in the control group[( 3.14 ± 0.12) d vs (5.02 ± 0.07) d,(11.23 ± 3.53) d vs (15.27 ± 2.11) d; P = 0.000, 0.007]. The complication rate of mechanical ventilation in the observation group was lower than that in the control group(6.25 % vs 15.63 %, P = 0.000). Conclusion Inhalation of Heliox under the support of SIMV can improve respiratory function, reduce inflammatory response, improve the level of miR-155, shorten treatment time and have high security.(英文摘要部分,需要修改) |
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