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신생아 호흡 곤란 증후군에서 Curosurf®와 Surfacten®의 치료 효과 비교

Comparison of Curosurf® versus Surfacten® in the Treatment of Respiratory Distress Syndrome

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목적 : 신생아의 호흡 곤란 증후군에 사용하는 Curosurf®와 Surfacten®의 효과를 비교하고자 본 연구를 실시하게 되었다. 방법 : 2007년부터 2009년까지의 의무기록을 후향적으로 분석하였다. 대상군을 Curosurf®를 사용한 20명과 Surfacten®를 사용한 21명의 군으로 나누었다. 재태 연령, 출생 시 체중, 분만 형태, 출생 후 1분과 5분 Apgar 점수, 산모의병력, 치료 시 나이, 기관지폐이형성증, 동맥관 개존증, 뇌실내 출혈, 괴사성 장염, 뇌실주위 백질연화증, 미숙아망막증, 폐출혈, 기흉, 인공 호흡기를 사용한 기간, 산소를 공급한 기간, 총 입원 기간 등을 조사하였다. 결과 : Curosurf®투여군과 Surfacten®투여군에서의 주산기 특징은 비슷하였다. Curosurf®투여군과 Surfacten®투여군에서 재태연령은 각각 32.7±3.1주, 30.5±4.3주였다(P=0.08). Curosurf®투여군에서 기관지폐이형성증으로 진행한 경우는 20명 중에서 6명이었고, Surfacten®투여군에서는 21명 중 8명으로 통계적으로 유의한 의미는 없었다(P=0.59). Curosurf®투여군과 Surfacten®투여군에서 괴사성 장염, 뇌실내 출혈, 뇌실주위 백질연화증, 미숙아 망막증, 폐출혈, 기흉은 통계적으로 유의한 차이가 없었다(IVH, P=0.14; PVL, P=0.94; ROP P=0.94; PTX,P=0.34). 인공호흡기를 사용한 기간이 Curosurf®투여군은 16.8±16.5일, Surfacten®투여군은 23.8±35.7일로통계적 차이는 없었다(P=0.43). 산소 치료를 한 기간과 전체 입원 기간에서도 통계적 차이가 없었다(P=0.92,0.91). 결론 : Curosurf®투여군과 Surfacten®투여군간의 일차 치료 경과와 이차적인 합병증 발생에 차이가 없음을 확인하였고, 최소 조작의 장점이 있는 Curosurf®의 사용이 추천된다.

Abstract

Purpose: The goal of this study was to compare the effects of treatment of newborn babies with two different surfactants, Curosurf® and Surfacten®. Methods: We retrospectively reviewed the medical records from 2007 to 2009 and divided the patients into two groups: those who received Curosurf® (n=20) and those who received Surfacten® (n=21). We compared the groups for sex, gestational age (GA), birth weight, type of delivery, apgar score, maternal history, age at treatment, bronchopulmonary dysplasia (BPD), administration indomethacin for patent ductus arteriosus(PDA), necrotizing enterocolitis (NEC), intraventricular hemorrhage (IVH), periventricular leucomalacia (PVL), retinopathy of prematurity (ROP), pulmonary hemorrhage (PH), pneumothorax (PTX), duration of ventilation, need for oxygen, and administration. Results: The demographic and clinical variables were similar in both groups. The gestational age for Curosurf® and Surfacten® were 32.7±3.1 and, 30.5±4.3 weeks, respectively (P=0.08). Six newborns in the Curosurf® group and 8 in the Surfacten® group developed BPD (P=0.59). No significant differences were noted for NEC, IVH, PVL, ROP, PH, PTX between the two groups (IVH, P=0.14; PVL, P=0.94; ROP P=0.94; PTX P=0.34). The mean duration of ventilation was 16.8 days with Curosurf® and 23.7 days with Surfacten®, but these differences were not statistically significant (P=0.43). The differences in duration of need for oxygen and administration were also not statistically significant (P=0.92, 0.91, respectively). Conclusion: This study indicated no significant differences between Curosurf® and Surfacten®. However, because of its convenience and the merit of minimal touching of the babies, the use of Curosurf® is recommended.

참고문헌 (22)

  1. Avery ME, "Surface properties in relation to atelectasis and hyaline membrane disease", AMA J Dis Child, 97, pp.517~523 (1959)
  2. Fujiwara T, "Artificial surfactant therapy in hyaline-membrane disease", Lancet, 1, pp.55~59 (1980)
  3. 김성미, "신생아 호흡곤란증후군에서 인공 폐 표면활성제 조기요법의 중요성과 필요성", Neonatal medicine, 16(2), pp.101~109 (2009), 대한신생아학회
  4. Namgung R, "Exogenous surfactant replacement therapy of hyaline membrane disease: a controlled clinical trial", J Korean Pediatr Soc, 33, pp.22~35 (1990)
  5. Bae CW, "Surfactant replacement therapy in neonates with respiratory distress syndrome: a collective evaluation of trials from 16 hospitals", J Korean Pediatr Soc, 36, pp.244~265 (1993)
  6. 배종우, "2010년 전국 72개 병원에서 신생아 호흡곤란증후군의 폐 표면활 성제 치료 결과: 지난 20년간의 비교", Neonatal medicine, 18(2), pp.409~411 (2011), 대한신생아학회
  7. Noack G, "Severe neonatal respiratory distress syndrome treated with the isolated phospholipid fraction of natural surfactant", Acta Paediatr Scand, 76, pp.697~705 (1987)
  8. Jun YH, "Exogenous pulmonary surfactant replacement therapy in severe respiratory distress syndrome: randomized controlled clinical trial between surfactant (surfacten and survanta)- treated group and control group", Korean J Perinatol, 4, pp.455~472 (1993)
  9. Lee EK, "Comparison of synthetic surfactant with modified bovine surfactant in neonatal respiratory distress syndrome", J Korean Soc Neonatol, 6, pp.154~161 (1999)
  10. Lee JJ, "Comparison of surfacten versus newfacten for the treatment of respiratory distress syndrome", J Korean Soc Neonatol, 7, pp.24~32 (2000)
  11. Choi Chang Won, "Comparison of Clinical Efficacy of Newfactan� versus Surfacten� for theTreatment of Respiratory Distress Syndrome in the Newborn Infants", Journal of Korean Medical Science, 20(4), pp.591~597 (2005), 대한의학회
  12. 홍석우, "신생아 호흡 곤란 증후군에서 CurosurfⓇ와 NewfactanⓇ의 치료 효과 비교", Neonatal medicine, 15(2), pp.142~150 (2008), 대한신생아학회
  13. 배종우, "Surfactant Therapy for Neonatal Respiratory Distress Syndrome: A Review of Korean Experiences over 17 Years", Journal of Korean Medical Science, 24(6), pp.1110~1118 (2009), 대한의학회
  14. Ramanathan R, "A randomized, multicenter masked comparison trial of poractant alfa (Curosurf ) versus beractant (Survanta) in the treatment of respiratory distress syndrome in preterm infants", Am J Perinatol, 21, pp.109~119 (2004)
  15. Speer CP, "Randomised clinical trial of two treatment regimens of natural surfactant preparations in neonatal respiratory distress syndrome", Arch Dis Child Fetal Neonatal Ed, 72, pp.F8~F13 (1995)
  16. Baroutis G, "Comparison of three treatment regimens of natural surfactant preparations in neonatal respiratory distress syndrome", Eur J Pediatr, 162, pp.476~480 (2003)
  17. Gharehbaghi MM, "Complications among premature neonates treated with beractant and poractant alfa", Indian J Pediatr, 77, pp.751~754 (2010)
  18. Dizdar EA, "A randomized, controlled trial of poractant alfa versus beractant in the treatment of preterm infants with respiratory distress syndrome", Am J Perinatol, 29, pp.95~100 (2012)
  19. Malloy CA, "A randomized trial comparing beractant and poractant treatment in neonatal respiratory distress syndrome", Acta Paediatr, 94, pp.779~784 (2005)
  20. Fujii AM, "Poractant alfa and beractant treatment of very premature infants with respiratory distress syndrome", J Perinatol, 30, pp.665~670 (2010)
  21. Soll RF, "Prophylactic natural surfactant extract for preventing morbidity and motality in preterm infants", Cochrane Database Syst Rev, (2), pp.CD000511~ (2000)
  22. 정기영, "Comparison of Outcomes between Prophylactic and Rescue Therapy of Surfactant in Premature Infants", Neonatal medicine, 20(1), pp.90~96 (2013), 대한신생아학회

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