表面活性剂对未成熟婴儿的充分性——产前诱导与产后治疗。

H W Taeusch, B T Smith
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引用次数: 0

摘要

对表面活性物质不足的产前和产后治疗进行综述。产前母亲糖皮质激素治疗促进肺成熟,提高新生儿肺表面活性物质水平,但至少需要24小时的治疗,即使在最佳条件下,治疗效果也有限。相对较少的早产妇女适合糖皮质激素治疗。糖皮质激素与激素(如甲状腺)和肾上腺素能药物联合使用的研究正在进行中。作者正在研究成纤维细胞-肺细胞因子(FPF)对胎儿肺表面活性物质系统的影响。几个中心研究了用充气的天然和人工表面活性剂进行产后治疗,取得了不同程度的成功。目前,风险:收益比倾向于通过产前表面活性剂诱导和产后替代治疗来降低呼吸窘迫综合征(RDS)的风险。对基本机制有了更深入的了解,就可以制定更令人满意的治疗办法。
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Surfactant sufficiency for immature infants--prenatal induction vs. postnatal treatment.

The prenatal and postnatal therapeutic management of surfactant insufficiency are reviewed. Prenatal maternal glucocorticoid therapy promotes lung maturation and enhances lung surfactant levels in the neonate, but a minimum of 24 hr treatment is required and the therapy is of limited effectiveness even under optimal conditions. Relatively few women in premature labour are good candidates for glucocorticoid therapy. Research into combinations of glucocorticoids with hormones (e.g. thyroid), and adrenergic agents in progress. The authors are studying the effects of fibroblast-pneumonocyte factor (FPF) on the fetal lung surfactant system. Postnatal therapy with insufflated natural and artificial surfactants has been studied in several centres with varying degrees of success. Currently, the risk:benefit ratios favour attempts to reduce the risks of respiratory distress syndrome (RDS) by both prenatal surfactant induction and postnatal replacement therapy. Greater understanding of the underlying mechanisms should permit the establishment of more satisfactory treatment.

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Small cell lung cancer. Small cell lung cancer. Monoclonal antibodies in lung cancer pathology. The rôle of proteases and antiproteases in bronchial secretions. Adverse effects of toxins and drugs on the surfactant systems.
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