早期雾化吸入布地奈德混悬液预防早产儿支气管肺发育不良的疗效和安全性分析

李盼盼; 赵武; 席康明; 王强生; 梅玮; 刘东梅; 尹远远; 王红燕

doi:10.13898/j.cnki.issn.1000-2200.2021.06.013

早期雾化吸入布地奈德混悬液预防早产儿支气管肺发育不良的疗效和安全性分析

Analysis of the efficacy and safety of early aerosol inhalation of budesonide suspension in the prevention of bronchopulmonary dysplasia in preterm infants

摘要

摘要:
目的探讨出生后早期雾化吸入布地奈德混悬液预防早产儿支气管肺发育不良(bronchopulmonary dysplasia，BPD)的疗效和安全性。
方法采用前瞻性随机队列研究设计，将2017年11月至2020年5月某院新生儿科收治的胎龄 < 32周且在出生后3 d内接受机械通气或经鼻持续气道正压通气的102例早产儿随机分为干预组(n=50)和对照组(n=52)，干预组雾化吸入布地奈德混悬液，对照组雾化吸入等量0.9%氯化钠溶液。比较2组主要结局和次要结局。
结果干预组BPD或死亡发生率低于对照组(P < 0.05)，干预组存活者BPD发病率低于对照组(P < 0.05)，2组死亡率差异无统计学意义(P>0.05)。干预组中重度BPD发病率低于对照组(P < 0.05)，2组轻度、中度、重度BPD发病率差异均无统计学意义(P>0.05)。干预组常压氧疗时间和住院时间均少于对照组(P < 0.01和P < 0.05)。2组并发症发生率、体质量变化值、血红蛋白、血小板、肝肾功能电解质及肺表面活性物质、枸橼酸咖啡因和地塞米松使用率均无统计学意义(P>0.05)。
结论出生后早期雾化吸入布地奈德混悬液可降低机械辅助通气早产儿BPD和中重度BPD的发病率，对死亡率无明显影响，无近期不良反应。

Abstract:
ObjectiveTo explore the efficacy and safety of early aerosol inhalation of budesonide suspension in the prevention of bronchopulmonary dysplasia(BPD) in preterm infants.
MethodsThis prospective randomized cohort study was conducted from November 2017 to May 2020 in the department of neonatology.A total of 102 preterm infants with gestational age < 32 weeks and admission within 3 days after birth received mechanical ventilation or nasal continuous positive airway pressure ventilation.The infants were randomly divided into intervention group(n=50) and control group(n=52).The intervention group received aerosol inhalation of budesonide suspension, and the control group received aerosol inhalation of equivalent volumes of 0.9% sodium chloride solution.The primary and secondary outcome were compared between the two groups.
ResultsThe incidence of BPD or death in intervention group was lower than that in control group(P < 0.05), the incidence of BPD in survival infants in intervention group was lower than that in control group(P < 0.05), and there was no significant difference in mortality between the two groups(P>0.05).The incidence of moderate and severe BPD in intervention group was lower than that in control group(P < 0.05), and there was no significant difference in incidence of mild, moderate and severe BPD between the two groups(P>0.05).The duration of atmospheric oxygen therapy and hospital stay in intervention group were significantly lower than those in control group(P < 0.01 and P < 0.05).There were no significant differences in the incidence of complications, body mass change, hemoglobin, platelet, electrolytes of liver and kidney function, and the utilization rate of pulmonary surfactant, caffeine citrate, and dexamethasone between the two groups(P>0.05).
ConclusionsEarly aerosol inhalation of budesonide suspension after birth can reduce the incidence of BPD and moderate to severe BPD in preterm infants with mechanically assisted ventilation, and has no significant effect on mortality and no short-term adverse reactions.

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