肺表面活性物质对新生儿呼吸窘迫综合征患儿血清Th1/Th2平衡的影响

翟淑芬,刘翠青,平莉莉,田宝丽

中国当代儿科杂志 ›› 2012, Vol. 14 ›› Issue (12) : 893-897.

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中国当代儿科杂志 ›› 2012, Vol. 14 ›› Issue (12) : 893-897.
论著·临床研究

肺表面活性物质对新生儿呼吸窘迫综合征患儿血清Th1/Th2平衡的影响

  • 翟淑芬,刘翠青,平莉莉,田宝丽
作者信息 +

Effect of pulmonary surfactant on Th1/Th2 balance in neonates with respiratory distress syndrome

  • ZHAI Shu-Fen, LIU Cui-Qing, PING Li-Li, TIAN Bao-Li
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文章历史 +

摘要

目的:探讨肺表面活性物质(PS)对新生儿呼吸窘迫综合征(NRDS)患儿血清Th1/Th2平衡和血清IgE浓度的影响。方法:纳入NRDS患儿共58名,其中未接受PS治疗、只给予机械通气和其他一般治疗的患儿 20例作为对照组;除机械通气及一般治疗外,入院1 h内应用牛肺表面活性剂治疗的患儿38例作为PS组。采用ELISA法检测两组患儿在治疗前及治疗后24、48、72 h血清中白细胞介素4(IL-4)、γ干扰素(IFN-γ)及IgE的浓度,同时记录动脉血气、呼吸系统顺应性等呼吸机参数。结果:PS组机械通气时间、氧暴露时间明显低于对照组(均P<0.05)。在治疗后24、48、72 h,PS组肺顺应性显著高于对照组,氧合指数显著低于对照组(P<0.05)。治疗后48和72 h,PS组IFN-γ血清浓度分别为120±46、141±40 ng/L,显著低于对照组(48和72 h分别为229±59、282±43 ng/L);IL-4血清浓度分别为263±48、417±49 pg/mL,显著高于对照组(48和72 h分别为152±45、201±46 pg/mL),差异均有统计学意义(P<0.05)。治疗后72 h,PS组血清IgE浓度(115±44 ng/mL)显著低于对照组(199±43 ng/mL)(P<0.05)。结论:PS不仅缩短机械通气和氧暴露时间,还可以调节血清IFN-γ、IL-4、IgE水平,影响Th1/Th2平衡,从而抑制肺部炎症反应,减轻肺损伤。

Abstract

OBJECTIVE: To investigate the effect of pulmonary surfactant (PS) on the Th1/Th2 balance and serum levels of interleukin-4 (IL-4), interferon-γ (IFN-γ) and IgE in neonates with respiratory distress syndrome (RDS). METHODS: A total of 58 neonates with RDS were divided into control (n=20) and PS treatment groups (n=38). The control group underwent mechanical ventilation and other conventional treatment, while the PS treatment group received with bovine PS treatment within 1 hour of being admitted to the hospital together with mechanical ventilation and other conventional treatment. Enzyme-linked immunosorbent assay was used to measure serum levels of IL-4, IFN-γ and IgE before treatment and 24, 48 and 72 hours after treatment. Simultaneously, arterial blood gas, respiratory system compliance, and other ventilator parameters were recorded. RESULTS: Compared with the control group, the PS treatment group showed significantly shorter duration of mechanical ventilation and oxygen exposure time (P<0.05), significantly better respiratory system compliance and significantly lower oxygenation index 24, 48 and 72 hours after treatment (P<0.05). At 48 and 72 hours after treatment, serum levels of IFN-γ were significantly lower in the PS treatment group than in the control group (120±46 ng/L vs 229±59 ng/L, P<0.05; 141±40 ng/L vs 282±44 ng/L, P<0.05), and serum levels of IL-4 were significantly higher in the PS treatment group than in the control group (263±48 pg/mL vs 152±45 pg/mL, P<0.05; 417±49 pg/mL vs 201±46 pg/mL, P<0.05). At 72 hours after treatment, serum level of IgE was significantly lower in the PS treatment group than in the control group (115±44 pg/mL vs 199±43 ng/mL; P<0.05). CONCLUSIONS: PS treatment can shorten the duration of mechanical ventilation and oxygen exposure time, regulate serum levels of IFN-γ, IL-4 and IgE, and influence Th1/Th2 balance in neonates with RDS, thus inhibiting lung inflammatory response and reducing lung injury.

关键词

呼吸窘迫综合征 / 肺表面活性物质 / Th1/Th2平衡 / 白细胞介素4 / γ干扰素 / 免疫球蛋白E / 新生儿

Key words

Respiratory distress syndrome / Pulmonary surfactant / Th1/Th2 balance / Interleukin-4 / Interferon-γ / IgE / Neonate

引用本文

导出引用
翟淑芬,刘翠青,平莉莉,田宝丽. 肺表面活性物质对新生儿呼吸窘迫综合征患儿血清Th1/Th2平衡的影响[J]. 中国当代儿科杂志. 2012, 14(12): 893-897
ZHAI Shu-Fen, LIU Cui-Qing, PING Li-Li, TIAN Bao-Li. Effect of pulmonary surfactant on Th1/Th2 balance in neonates with respiratory distress syndrome[J]. Chinese Journal of Contemporary Pediatrics. 2012, 14(12): 893-897
中图分类号: R722.1   

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