目的 探討吸入用布地奈德混懸液聯(lián)合豬肺磷脂注射液對(duì)重度新生兒呼吸窘迫綜合征患兒肺功能的影響。方法 選取2016年8月-2018年7月南京市大廠醫(yī)院收治的重度新生兒呼吸窘迫綜合征（NRDS）患兒61例為研究對(duì)象，根據(jù)隨機(jī)數(shù)字表法分為兩組。對(duì)照組給予豬肺磷脂注射液聯(lián)合機(jī)械通氣治療，100 mg/kg氣管內(nèi)給藥，用藥時(shí)升溫至37℃搖勻，用無(wú)菌注射器抽取。觀察組在對(duì)照組的基礎(chǔ)上給予吸入用布地奈德混懸液0.25 mg/kg霧化吸入。比較兩組患兒的臨床治療效果、肺功能相關(guān)指標(biāo)及血清鐵蛋白（SF）和纖溶酶原激活物抑制劑-1（PAI-1）表達(dá)水平。結(jié)果 觀察組的總有效率為93.55%，高于對(duì)照組的73.33%，組間差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療前兩組患兒動(dòng)脈血氧分壓（pO₂）、動(dòng)脈二氧化碳分壓（pCO₂）、吸氧濃度（FiO₂）和氧合指數(shù)（OI）無(wú)統(tǒng)計(jì)學(xué)差異；治療后pO₂和OI顯著升高，pCO₂和FiO₂顯著下降，同組治療前后比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；觀察組pO₂和OI顯著高于對(duì)照組，pCO₂顯著低于對(duì)照組，組間差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。兩組治療前SF和PAI-1表達(dá)水平無(wú)統(tǒng)計(jì)學(xué)差異；治療后SF和PAI-1均顯著降低，同組治療前后比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；且觀察組低于對(duì)照組，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論 吸入用布地奈德混懸液聯(lián)合豬肺磷脂注射液可顯著降低重度新生兒呼吸窘迫綜合征患兒的SF和PAI-1表達(dá)水平，改善患兒肺功能，提高臨床治療效果。

Objective To investigate the effects of Budesonide Suspension for Inhalation combined with Poractant Alfa Injection on pulmonary function in children with severe neonatal respiratory distress syndrome. Methods 61 cases of children with severe neonatal respiratory distress syndrome (NRDS) were selected from August 2016 to July 2018 in Nanjing Dachang Hospital were divided into two groups according to random number table method. The control group given Poractant Alfa Injection combined with mechanical ventilation therapy, and intratracheal administration of 100 mg/kg was given. The medication was warmed up to 37℃, shaken and extracted with sterile syringe. The observation group given Budesonide Suspension for Inhalation 0.25 mg/kg aerosol inhalation on the basis of control group. The clinical therapeutic effects, related parameters of lung function and serum SF, PAI-1 expression level were compared between two groups. Results The total effective rate of the observation group was 93.55%, which was significantly higher than 73.33% of the control group (P<0.05). pO₂, pCO₂, FiO₂ and OI were no statistical difference between two groups before treatment. After treatment, pO₂ and OI were significantly increased, but pCO₂ and FiO₂ were significantly decreased, and the difference was statistically significant in the same group (P<0.05). After treatment, pO₂ and OI in observation group were significantly higher than those in the control group, pCO₂ was significantly lower than that of control group, with significant difference between two groups (P<0.05). There was no statistically significant difference in SF and PAI-1 expression between the two groups before treatment. After treatment, SF and PAI-1 were significantly reduced, and the difference was statistically significant in the same group (P<0.05). And the observation group was lower than the control group, with significant difference between two groups (P<0.05). Conclusion Budesonide Suspension for Inhalation combined with Poractant Alfa Injection can significantly reduce the expression of SF and PAI-1 in children with severe neonatal respiratory distress syndrome, improve the lung function, and improve the clinical treatment effect.