1992 Fiscal Year Annual Research Report

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 Institution	Iwate 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)
Keywords	syndrome / artificial surfactant / morphometry
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。

Research Products

(8 results)

All Other

All Publications (8 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)
[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)
[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)
[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)
[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)
[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)
[Publications] T.Fujiwara,S.chida,M.Konishi: "Perinatology:Surfactant replacement therapy:Benefits and risks." ed.by E.Saling Nestle Nutrition Workshop Series, 18 (1992)
[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)

1992 Fiscal Year Annual Research Report

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

Principal Investigator

藤原 哲郎 岩手医科大学, 医学部, 教授 (10004847)

Research Products

[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)

[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)

[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)

[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)

[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)

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

[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)

藤原哲郎岩手医科大学, 医学部, 教授 (10004847)