A Clinical Research On The Application Of Different Mechanical Ventilation Modes And The Variation Of Biomarkers In Premature Infants With RDS

Objective: To investigate the treatment outcomes of pressure regulated volume control(PRVC)mode and synchronized intermittent mandatory ventilation(SIMV)mode ventilation on neonatal respiratory distress syndrome(NRDS)in premature infants,and compare the differential expression of some biological indexes in the serum of preterm infants with NRDS so as to find the early marker of BPD.Methods: A total of 30 premature infants with serious NRDS were randomly divided into group A(n=15,received PRVC mode)and group B(n=15,received SIMV mode).15 preterm infants without serious NRDS were included in the control group.1.To compare the effects,complications and outcomes between group A and group B.2.To compare the differential expression of biological indexes(TNF-α、IL-6、IL-8、IL-10、VEGF、FGF and TGF-β1)in the serum of preterm infants with NRDS by Cytometric Bead Array(CBA)and analyze the correlations between those indexes and the course of oxygen inhalation,and the morbidity of bronchopulmonary dysplasia(BPD).Results: 1.Results of the clinical data.(1)Compared with group B,the difference value of Oxygenation Index(OI)between 72 h and 0h is significant higher in group A(P <0.05).But there is no significant difference in OI at 0h,24 h,48h,72 h,24h-0h and 48h-0h between the two groups(P >0.05).(2)There is no significant difference in the duration of ventilation,course of oxygen inhalation and usage of twice doses of pulmonary surfactant(PS)between the two groups(P >0.05).(3)There is no significant difference in the morbidity of BPD、VAP、PDA、IVH(grade IV)and ROP between the two groups(P >0.05).(4)There is no significant difference in the improvement rate,hospital stay and hospitalization expenses between the two groups(P >0.05).(5)There is no significant difference in MDI and PDI at corrected gestational age of 3 months between the two groups(P >0.05).2.Results of the laboratory’s data.(1)Compared with group C,the expression level of IL-10(0d)、IL-10(0d-14d)were significantly higher in group A and B(P <0.05).But there is no significant difference in the expression level of IL-10(14d)among the three groups.(2)There is no significant difference in the expression level of VEGF(0d)、VEGF(14d)、VEGF(0d-14d)、TGF-β(0d)、TGF-β(14d)and TGF-β(14d-0d)among the three groups(P >0.05).(3)There is a significant correlation between the expression level of IL-10(0d)and the course of oxygen inhalation(r=0.438,P <0.01).And significant correlation also could be seen between the expression level of IL-10(0d)and the morbidity of BPD(r=0.609,P <0.01).Conclusion: 1.Compared with traditional SIMV mode,the PRVC mode could promote oxygenation more quickly in the first 72 hours without raised morbidity of complications.PRVC could be chosen as a more suitable mode for NRDS in preterm infants.2.The expression level of IL-10 was significantly higher in serious NRDS group during the first day and declined in the subsequent two weeks.And it was significantly relevant with the course of oxygen inhalation and the morbidity of BPD.It is expected that IL-10 could be the new biological marker for the early diagnosis of serious NRDS and BPD.