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新生児呼吸窮迫症候群のサーファクタント補充療法ーSurfactant TAと他のsurfactantとの物理化学的、生理学的、形態学的比較検討

Research Project

Project/Area Number 02454274
Research Category

Grant-in-Aid for General Scientific Research (B)

Allocation TypeSingle-year Grants
Research Field Pediatrics
Research InstitutionIwate Medical University

Principal Investigator

藤原 哲郎  岩手医科大学, 医学部, 教授 (10004847)

Co-Investigator(Kenkyū-buntansha) 前多 治雄  岩手医科大学, 医学部, 助手 (20108955)
千田 勝一  岩手医科大学, 医学部, 講師 (30108930)
鈴木 一彦  岩手医科大学, 医学部・小児科, 副手
高橋 明雄  岩手医科大学, 医学部・小児科, 助手 (70163235)
Project Period (FY) 1990 – 1992
Project Status Completed (Fiscal Year 1992)
Budget Amount *help
¥6,000,000 (Direct Cost: ¥6,000,000)
Fiscal Year 1992: ¥600,000 (Direct Cost: ¥600,000)
Fiscal Year 1991: ¥2,700,000 (Direct Cost: ¥2,700,000)
Fiscal Year 1990: ¥2,700,000 (Direct Cost: ¥2,700,000)
Keywordssyndrome / artificial surfactant / morphometry / 人工サ-ファクタント / 新生児呼吸窮迫症候群 / 肺機能 / 肺胞安定性 / 未熟ウサギ為仔 / 画像解析 / surfactant / SurfactantーTA / 表面吸着 / 表面張力
Research Abstract

新生児呼吸窮迫症候群(RDS)の治療法として我々が開発し、現在本邦で実用化されているSurfactant TA(S-TA)と諸外国で臨床試験中、あるいは、すでに実用化されている6種類のSurfactantの効果を未熟ウサギ胎仔(胎生27日)に経気道的に投与した場合のalveolar expansion indexを用いて比較した。
【各種Surfactantの作製】(1)ブタ肺リン燐脂質分画(Curosurf相当),(2)牛肺洗浄液surfactant脂質(CLSE),(3)purified natural surfactant(PNS),(4)DPPC:PG(ALEC)は各々の原法に従い作製し,(5)ExosurfはBurroughs Wellcome社(USA)より購入,(6)SurvantaはAbbott Internationalより提供を受けた。
【方法・対象】未熟ウサギ胎仔(胎生27±3時間,n=342)をhysterotomyで娩出し、S-TAと他の6種類のsurfactantの経気道投与後(dose-response15,30,50,100,200mg/kg)の肺コンプライアンスを測定後、10cmH_2Oの気道内圧でフォルマリン固定し、肺の薄切り切片(各肺6切片)をHE染色後、肺胞の拡張の程度(alveolar expansion index)をIBASを用いて、画像解析した。mature fetus(n=19)と未熟ウサギ胎仔(胎生27日±3時間,n=19)を対照とした。
【結果】画像解析は総計2041回行なった。S-TA群はmature controlのレベルにまでalveolar expansionを改善し、他のいずれのsurfactantよりも有意に高いalveolar expansion indexを示した。英国のALECと米国のExosurfは200mg/kgでさえ未熟ウサギ胎仔と差がなく、10cmH_2Oのtranspulmonary pressureでは肺胞は虚脱を示した。Curosurf,CNS,Survantaは、いずれも100mg/kgの濃度ではS-TAより有意に低いalveolar expansion indexを示した。
【結論】Surfactant TAは、他の6種類のsurfactantのいずれよりも優れたsurfactantであることが証明された。

Report

(3 results)
  • 1992 Annual Research Report
  • 1991 Annual Research Report
  • 1990 Annual Research Report
  • Research Products

    (12 results)

All Other

All Publications (12 results)

  • [Publications] T.Fujiwara,M.Konishi,S.Chida,et al: "Surfactant replacement therapy with a single postventilatory dose of a reconstituted bovine surfact ant in preterm neonates with resperatory distress syndrome:Final analysis of a multicenter doubleblind,randomized trial and comparison with similar trials." Pediatrics. 86. 753-764 (1990)

    • Related Report
      1992 Annual Research Report
  • [Publications] S.Chida,D.S.Phelps,R.F.Soll,et al: "Surfactant proteins and antisurfactant antibodies in sera from infants with respiratory distress syndrome with or without surfactant treatment." Pediatrics. 88. 84-89 (1991)

    • Related Report
      1992 Annual Research Report
  • [Publications] M.Konishi,T.Fujiwara,S.chida,et al: "A prospective,randomized trial of early versus late administration of a single dose of surfactant TA," Early Human Development. 29. 275-282 (1992)

    • Related Report
      1992 Annual Research Report
  • [Publications] M.Konishi,S.Chida,S.Shimada,et al: "Surfactamt replacement therapy in premature babies with respiratory distress syndrome:Factors affecting the response to surfactant and comparison of outcome from 1982-86 and 1987-91." Acta Paediatr Jpn.34. 617-630 (1992)

    • Related Report
      1992 Annual Research Report
  • [Publications] S.Chida and T.fujiwara: "Stable microbubble test for predicting the risk of respiratory distress syndrome:I.Comparison with other predictors of fetal lung maturity in amniotic fluid." Eur.J.Pediatr.152. 148-151 (1993)

    • Related Report
      1992 Annual Research Report
  • [Publications] S.Chida,T.Fujiwara M.Konishi,et al: "Stable microbubble test for predicting respiratory distress syndrome.II.Prospective evaluation of the test on amniotic fluid and gastric aspirate." Eur.J.Pediatr.152. 152-156 (1993)

    • Related Report
      1992 Annual Research Report
  • [Publications] T.Fujiwara,S.chida,M.Konishi: "Perinatology:Surfactant replacement therapy:Benefits and risks." ed.by E.Saling Nestle Nutrition Workshop Series, 18 (1992)

    • Related Report
      1992 Annual Research Report
  • [Publications] T.Fujiwara,M.Konishi,S.Chida: "Neonataltherapeutics:chapter 6 Surfactant therapy in neonatal respiratory distress syndrome." ed.by Yeh,T.F.,Mosby Year Book, 17 (1991)

    • Related Report
      1992 Annual Research Report
  • [Publications] Haruo Maeta,et al: "Effects of early(EーRx)versus late(LーRx)surfactant treatment on pulmonary mechanics(PM)in preterm infants." Pediatric Research. 29. 323A- (1991)

    • Related Report
      1991 Annual Research Report
  • [Publications] Haruo Maeta,et al: "Dose response studies of three different surfactant" Pediatric Research. 29. 224A (1991)

    • Related Report
      1991 Annual Research Report
  • [Publications] Akio Takahashi,et al: "Effect of pulmonary surfacatant protein(SP)ーA SPーB,and SPーC on the in vitro surfactant activity;SPーB and SPーC act cooperatively." Pediatric Research. 29. 338A (1991)

    • Related Report
      1991 Annual Research Report
  • [Publications] Senji Shimada,et al: "Response to surfactant therapy in RDSーinfants with “early"large leftーtoーright shunt PDA." Pediatric Research. 29. 234A (1991)

    • Related Report
      1991 Annual Research Report

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Published: 1990-04-01   Modified: 2016-04-21  

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