[胃内容物微吸相关支气管肺发育不良的发病率、病理形态及预后]。

E Y Bryksina, V S Bryksin, A V Pochivalov
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引用次数: 0

摘要

未标记:目前,消化道功能违规后胃内容物微吸(MAGC)对支气管肺发育不良(BPD)的发生率、特征和结局的影响研究甚少。对这方面的关注使研究具有现实性。目的:确定MAGC对BPD进展和病程的影响性质。方法:对373例新生儿进行新生儿期人工肺通气(APV)检查。在气管支气管抽吸(TBA)中测定了magc -胃蛋白酶的标志物。通过消光值测量其活性,随后分析MAGC和无MAGC患者支气管肺发育不良(BPD)病程的发生率和性质。在三年的随访期间,确定了BPD的预后和联合病理特征。结果:MAGC患儿BPD发生率较高,且与TBA胃蛋白酶活性升高和胎龄降低成正比。随着TBA值的消失增加,APV持续时间和随后的氧疗时间增加,BPD临床病程的严重程度也随之增加。到3年结束时,55.2%的无MAGC的BPD患儿临床恢复,而在有MAGC的BPD患者中,这一结果仅发生在0.9%的病例中。结论:MAGC对BPD的病因、发病机制和病理形态具有临床意义。提出的早期发现MAGC的方法和综合治疗算法可以降低其严重程度,提高新生儿适应预测的准确性。
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[Incidence, pathomorphism and outcomes of the bronchopulmonary dysplasia associated with microaspiration of gastric contents].

Unlabelled: Today the influence of the digestive tract functional violations followed by microaspiration of gastric contents (MAGC) on the incidence, features and outcomes of bronchopulmonary dysplasia BPD) remains little studied. Focusing on this aspect makes the research actual.

Objective: determination of the nature of influence of MAGC on the progress and course of BPD.

Methods: 373 newborns exposed to artificial pulmonary ventilation (APV) in the neonatal period were examined. In a tracheobronchial aspirate (TBA) the marker of MAGC-pepsin--was determined. Its activity was measured by extinction value with subsequent analysis of the incidence and nature of the course of bronchopulmonary dysplasia (BPD) in patients against MAGC and without it. During the three years follow-up period outcomes of BPD and features of combined pathology were established.

Results: it was revealed that in children suffered from MAGC the incidence of BPD was higher and grew in proportion to the increase of pepsin activity in TBA and the reduction of gestational age. The extinction increase in TBA values was followed by the increase in duration of APV and the subsequent oxygen therapy, and also the severity of BPD clinical course. By the end of 3 years clinical recovery was detected in 55.2% of children suffering from BPD without MAGC whereas in patients with BPD against MAGC this outcome occured only in 0.9% of cases.

Conclusion: MAGC is clinically significant for the etiology, pathogenesis and pathomorphism of BPD. The proposed method of early detection of MAGC and algorithm of complex therapy can reduce its severity and improve the forecast accuracy of neonatal adaptation.

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CiteScore
1.50
自引率
0.00%
发文量
31
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