摘要
目的探讨氢氯噻嗪联合肺表面活性物质(PS)对早产儿支气管肺发育不良(BPD)的治疗效果及对血清白细胞介素-6(IL-6)、肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)和乳酸脱氢酶(LDH)水平的影响。方法回顾性分析2020年12月至2023年12月浙江省舟山市妇女儿童医院新生儿重症监护室(NICU)收治的78例早产儿资料,根据治疗方案分为2组,PS组(选择PS治疗的患儿)和PS+氢氯噻嗪组(选择氢氯噻嗪联合PS治疗的患儿),经倾向性评分匹配后获得39对病例,评定2组治疗72 h后的临床疗效,对比2组呼吸暂停时间、吸氧时间、机械通气时间、住院时间,比较2组治疗前后的血气指标[动脉血酸碱度(pH值)、动脉二氧化碳分压(PCO_(2))、动脉血氧分压(PO_(2))]和血清IL-6、CK、CK-MB及LDH水平变化。结果相较于PS组,PS+氢氯噻嗪组的临床总有效率较高(95%和77%,P<0.05);相较于PS组,PS+氢氯噻嗪组的呼吸暂停时间、吸氧时间、机械通气时间、住院时间均缩短(P<0.05);治疗后,PS+氢氯噻嗪组早产儿的pH值、PaO_(2)均高于治疗前和PS组(P<0.05),PCO_(2)均低于治疗前和PS组(P<0.05);治疗后,2组的血清IL-6、CK、CK-MB及LDH水平均较治疗前下降(P<0.05),其中PS+氢氯噻嗪组下降幅度较PS组更显著(P<0.05);2组均未见明显不良反应。结论氢氯噻嗪联合肺表面活性物质治疗早产儿BPD的疗效确切,能改善患儿临床指标和血气指标,降低血清IL-6、CK、CK-MB及LDH水平,减轻肺部炎症,对神经系统发育起到保护作用,临床安全性良好。
Objective To investigate the therapeutic effect of hydrochlorothiazide combined with pul-monary surfactant(PS)on bronchopulmonary dysplasia(BPD)in premature infants and its impact on serum inter-leukin-6(IL-6),creatine kinase(CK),creatine kinase isoenzyme(CK-MB),and lactate dehydrogenase(LDH)lev-els.Methods A retrospective analysis was conducted on the data of 78 premature infants admitted to the neona-tal intensive care unit(NICU)of Zhoushan Women and Children's Hospital in Zhejiang Province from December 2020 to December 2023.The infants were divided into two groups based on different treatment regimens:those who received PS treatment(PS group)and those who received hydrochlorothiazide combined with PS treatment(PS+hydrochlorothiazide group).After propensity score matching,39 pairs of patients were obtained.After 72 hours of treatment,the clinical efficacy of the two groups was evaluated.The apnea time,oxygen inhalation time,mechani-cal ventilation time and hospital stay as well as changes of blood gas indicators[arterial blood potential of hydro-gen(pH),arterial partial pressure of carbon dioxide(PCO_(2)),arterial partial pressure of oxygen(PO_(2))]and serum IL-6,CK CK-MB,and LDH before and after treatment were compared between groups.Results Compared with PS group,the improvement of total clinical effective rate in PS+hydrochlorothiazide group was more significant(95%vs 77%,P<0.05).The apnea time,oxygen inhalation time,mechanical ventilation time and hospital stay in PS+hy-drochlorothiazide group were significantly shortened,and were shorter than those in PS group(P<0.05).After treat-ment,the pH and PO_(2) of premature infants in PS+hydrochlorothiazidegroup were higher than those before treatment and those in PS group (P<0.05) while the PCO_(2) was lower than that before treatment and that in PS group (P<0.05). The levels of serum IL-6, CK, CK-MB, and LDH in both groups were significantly decreased after treatment compared to before treatment (P<0.05), and the decreases in PS+hydrochlorothiazide group were mo
作者
王梦洁
邹小卫
顾轩欣
Wang Mengjie;Zou Xiaowei;Gu Xuanxin(Department of Pediatrics,Zhoushan Women and Children′s Hospital,Zhoushan,Zhejiang 316000,China)
出处
《中国药物与临床》
CAS
2024年第11期722-726,共5页
Chinese Remedies & Clinics
关键词
氢氯噻嗪
肺表面活性物质
早产儿
支气管肺发育不良
血气分析
白细胞介素-6
肌酸激酶
肌酸激酶同工酶
乳酸脱氢酶
Hydrochlorothiazide
Pulmonary surfactant
Premature infants
Bronchopulmonary dys-plasia
Blood gas analysis
Interleukin-6
Creatine kinase
Creatine kinase isoenzyme
Lactate dehydrogenase
