Effect Of Expression Of Caspase-3 And Bcl-2 In Bronchoalveolar Lavage Fluid Of Neonatal Respiratory Distress Syndrome By High Frequency Oscillatory Ventilation

Background and Objective Neonatal respiratory distress syndrome is a progressive dyspnea as the main performance of neonatal intensive respiratory system disease.High frequency oscillatory ventilation(HFOV)lung protective ventilation strategy,can without any increase in air pressure under the premise of effectively improve oxygenation and,in turn,reduce the aeration time,reduce pulmonary complications such as leakage gas,has been widely used in clinical.Traditional ventilation modes such as CMV,is likely to be higher oxygen concentration or high airway pressure can keep the same oxygenation and HFOV mode function,further increase the damage in the airways and alveoli.Apoptosis plays an important role in cellular damage process.Caspase 3 and the Bcl-2 plays an important role in cell apoptosis.In order to further HFOV to neonatal RDS respiratory secretions Caspase 3 and the influence of the Bcl-2.This study based on RDS Caspase 3 in children with bronchial alveolar lavage fluid and detects the Bcl-2 levels.Explore HFOV to neonatal RDS respiratory secretions Caspase 3,and the influence of the Bcl – 2.MethodsIn May 2015 to May 2016 in our hospital neonatal intensive care unit(NICU)of 90 cases of NRDS mechanical ventilation were among them 78 cases of children with NRDS meet the inclusion criteria,according to gender,gestational age,body weight were randomly divided into children HFOV group 39 cases and CMV,39 cases.On two groups of children,in front of the computer,computer after 12 h,24 h,48 h of Fi O2,MAP,OI values for testing,and the patient’s hospital stay,aeration time and the cure rate of the two groups,mortality and incidence of VILI.And the children of Caspase 3 in bronchoalveolar lavage fluid were compared with the Bcl-2 levels.Result HFOV group of Caspase 3 expression of average positive area(38.21 + 9.07)%,CMV group of Caspase 3 express the average positive area(51.08 + 12.48)%.CMV group of average positive area of Caspase 3 expression was obviously higher than that of HFOV group,statistically significant difference(t = 21.84,P = 21.84).By quantitative PCR detection CMV group expression of Bcl-2 quantity(1.00 + 0.10)for 2-delta delta ct,HFOV group expression of Bcl-2 quantity(4.86 + 0.61)for 2-delta delta ct,the expression of Bcl-2 quantity of CMV group was obviously lower than that of HFOV group,the difference is statistically significant(t = 39.77,P = 0.000).HFOV group to complete the test in 34 cases,including 1 cases died(2.94%),HFOV group average of aeration time was(12.5 + 0.8)d,average hospitalization time was(24.4 + 3.7)d;CMV group to complete the test in 32 cases,among them 6 cases died(18.5%),average time of ventilation for CMV group(18.9 + 0.7)d,average hospitalization time was(31.6 + 5.1)d,ventilation time of HFOV group was obviously shorter than the control group,the difference is statistically significant(t = 12.039,P = 0.000).Length of hospital stay of HFOV group was obviously shorter than the control group.The mortality rate of CMV group was obviously higher than control group,significant difference statistically significant(X2 = 4.345,P = 0.037)IVH1 in HFOV group(2.94%),PPNH2 cases(5.88%),occurred in CMV group IVH6 cases(18.75%),PPNH8 cases(25.00%),the incidence of the IVH and PPNH CMV group was obviously higher than control group,difference has significant statistical difference(X2 = 4.345,4.477,P = 0.037,0.034).Angry HFOV group found in 2 cases(5.88%),lung infection in 5 cases(14.71%),CMV group found angry leakage in 3 patients(9.38%),6 cases of pulmonary infection(18.75%).CMV and HFOV group gas leakage and the incidence of pulmonary infection in no statistical differences(X2 = 0.251,0.194,P = 0.616,0.660).Children in front of the computer OI values no statistical difference(t = 0.241,P = 0.241).The influence of different treatment and time on OI have interactive effect(F = 9.592,P = 9.592).Computer,different methods of treatment,children with OI value in computer after 12 h,24 h,48 h point were statistically difference(t value were 12.943,17.427,15.304;P < 0.05);Children in front of the computer Fi O2 value no statistical difference(t = 0.134,P = 0.134).The influence of different treatment methods and time of Fi O2 with interaction effect(F = 7.732,P = 7.732).Computer after different treatment,children with Fi O2 value in computer after 12 h,24 h,48 h point were statistically difference(t value were 8.282,7.927,7.843;P values are less than 0.05).Children in front of the computer MAP value no statistical difference(t = 0.455,P = 0.455).The influence of different treatment methods and time of Fi O2 with interaction effect(F = 12.420,P = 12.420).Computer,different methods of treatment,children with MAP value in computer after 12 h,24 h,48 h point were statistically difference(t value were 6.882,7.031,7.921;P values are less than 0.05).ConclusionHFOV can significantly improve the hypoxia state of neonatal respiratory distress syndrome,improve oxygenation and reduce the incidence of some complications.High frequency oscillatory ventilation compared with Chang Pin mechanical ventilation,can significantly reduce the lower concentration of Caspase 3,improve the Bcl-2 levels.