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发育医学电子杂志  2024, Vol. 12 Issue (1): 25-29    DOI: 10.3969/j.issn.2095-5340.2024.01.005
  围产医学   论著 |新生儿 |
肺表面活性物质蛋白- B 缺陷与足月新生儿呼吸窘迫综合征的相关性研究
尹晓娟 李明霞 史源 梅花 张晓媛 朱艳萍 霍梦月 封志纯
(1. Beijing Key Laboratory of Pediatric Organ Failure, National Engineering Laboratory for
Birth Defects Prevention and Control of Key Technology, Institute of Pediatrics, the Seventh Medical
Center of PLA General Hospital, Faculty of Pediatrics, the Chinese PLA General Hospital, Beijing
100700, China; 2. Department of Neonatology, the First Affiliated Hospital of Xinjiang Medical University,
Xinjiang, Urumqi 830054, China; 3. Department of Neonatology, Children’s Hospital of Chongqing Medical
University, Chongqing 401122, China; 4. Department of Neonatology, the Affiliated Hospital of Inner
Mongolia Medical University, Inner Mongolia, Huhhot 010050, China)
Research on the correlation between pulmonary surfactant protein B deficiency and neonatal respiratory distress syndrome in full-term newborns
Yin Xiaojuan, Li Mingxia, Shi Yuan, et al
(1. Beijing Key Laboratory of Pediatric Organ Failure, National Engineering Laboratory for
Birth Defects Prevention and Control of Key Technology, Institute of Pediatrics, the Seventh Medical
Center of PLA General Hospital, Faculty of Pediatrics, the Chinese PLA General Hospital, Beijing
100700, China; 2. Department of Neonatology, the First Affiliated Hospital of Xinjiang Medical University,
Xinjiang, Urumqi 830054, China; 3. Department of Neonatology, Children’s Hospital of Chongqing Medical
University, Chongqing 401122, China; 4. Department of Neonatology, the Affiliated Hospital of Inner
Mongolia Medical University, Inner Mongolia, Huhhot 010050, China)
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摘要 【摘要】 目的  探讨肺表面活性物质蛋白(surfactant protein,SP)-B 缺陷与足月儿新生儿呼吸窘迫综合
征(neonatal respiratory distress syndrome,NRDS)的相关性。 方法 2019 年7 月至2023 年6 月,在
解放军总医院第七医学中心等4 家医院开展研究。NRDS 组纳入因患NRDS 死亡的足月新生儿60 例;对照组纳入同期因其他原因手术后死亡的足月、非NRDS 患儿60 例。采集胸部X 线片结果。新生儿死亡后 30 min 内进行支气管肺泡灌洗、肺组织取材,采用蛋白质印迹法检测SP-B 表达。统计学方法采用χ2 检验。 结果  NRDS 组患儿生后出现严重高碳酸血症和低氧血症,采用外源性肺表面活性物质、有创高频振荡通气呼吸支持、一氧化氮治疗降低肺动脉高压等综合治疗措施,10 例接受体外膜肺氧合治疗,均治疗无效死亡。NRDS 组的X 线胸片均显示白肺。NRDS 组患儿支气管肺泡灌洗液中SP-B 单体(分子质量8 ku)及二聚体(分子质量16~18 ku)表达阳性的比例均明显低于对照组[8 ku :75.0%(45/60)与100.0%(60/60),χ2=17.143 ;16~18 ku :73.3%(44/60)与100.0%(60/60),χ2=18.462 ;P 值均<0.001];NRDS 组肺组织中SP-B 分子质量8 ku 及16~18 ku 表达阳性的比例也明显低于对照组[8 ku :75.0%(45/60)与100.0%(60/60),χ2=17.143 ;16~18 ku :70.0%(42/60)与100.0%(60/60),χ2=21.176 ;P 值均<0.001]。NRDS 组筛出SP-B 缺陷个体15 例,对照组仅1 例,NRDS 组SP-B 缺陷的比例高于对照组[25.0%(15/60)与1.7%(1/60),χ2=14.135,P<0.001]。 结论 SP-B 缺陷与足月儿NRDS 发病存在一定的相关性。
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关键词:  足月新生儿  呼吸窘迫综合征  肺表面活性物质蛋白-B   缺陷  遗传    
Abstract: 【Abstract】 Objective To explore the correlation between pulmonary surfactant protein (SP) -B deficiency and neonatal respiratory distress syndrome (NRDS) in full-term newborns. Method From July 2019 to June 2023, research was conducted in the Seventh Medical Center of PLA General Hospital and the other three hospitals. 60 full-term newborns who died with NRDS were included in the NRDS group. The control group included 60 full-term newborns with non-NRDS who died after surgery due to other reasons during the same period. Chest X-ray results were collected. Within 30 min after the newborns died, bronchoalveolar lavage and lung tissue sampling were performed. SP-B expression was detected using Western blotting. Chisquare test was used for statistical methods. Result Newborns in the NRDS group experienced severe hypercapnia and hypoxemia after birth. Adopting comprehensive treatment measures such as exogenous pulmonary surfactant, invasive high-frequency oscillatory ventilation respiratory support, nitric oxide therapy to reduce pulmonary arterial hypertension, etc. Ten cases received extracorporeal membrane oxygenation (ECMO). However, all of them died. Chest X-rays in the NRDS group all showed white lungs. The proportion of positive expression of SP-B monomers (molecular weight 8 ku) and dimers (molecular weight 16-18 ku) in bronchoalveolar lavage fluid of newborns in the NRDS group was significantly lower than that in the control group [8 ku: 75.0% (45/60) vs 100.0% (60/60), χ2=17.143; 16-18 ku: 73.3% (44/60) vs 100.0% (60/60),χ2=18.462; P<0.001]. The proportion of positive expression of SP-B monomers and dimers in lung tissue of the NRDS group was significantly lower than that of the control group [8 ku: 75.0% (45/60) vs 100.0% (60/60),
χ2=17.143; 16-18 ku: 70.0% (42/60) vs 100.0% (60/60), χ2=21.176; P<0.001]. Fifteen newborns with SP-B deficiency were detected in the NRDS group, while one with SP-B deficiency was detected in the control group. The proportion of SP-B deficiency in the NRDS group was significantly higher than that in the control group [25.0% (15/60) vs 1.7% (1/60), χ2=14.135, P<0.001]. Conclusion SP-B deficiency is corrected with NRDS in full-term newborns to some extent.
Key words:  Full-term newborn    Respiratory distress syndrome    Surfactant protein B    Deficiency    Inheritance
收稿日期:  2023-12-18                     发布日期:  2024-01-31     
基金资助: 国家自然科学基金(30871397)
通讯作者:  封志纯    E-mail:  zhjfengzc@126.com
引用本文:    
尹晓娟 李明霞 史源 梅花 张晓媛 朱艳萍 霍梦月 封志纯. 肺表面活性物质蛋白- B 缺陷与足月新生儿呼吸窘迫综合征的相关性研究[J]. 发育医学电子杂志, 2024, 12(1): 25-29.
Yin Xiaojuan, Li Mingxia, Shi Yuan, et al. Research on the correlation between pulmonary surfactant protein B deficiency and neonatal respiratory distress syndrome in full-term newborns. Journal of Developmental Medicine(Electronic Version), 2024, 12(1): 25-29.
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