枸橼酸咖啡因治疗极低出生体重早产儿呼吸暂停的临床研究  

CLINICAL STUDY OF CAFFEINE CITRATE ON THE TREATMENT OF APNEA OF PREMATURITY IN VERY LOW BIRTH WEIGHT INFANTS

作　　者：何焱志 黄梅[1] 

机构地区：[1]湖北省十堰市妇幼保健院新生儿科,十堰442000

出　　处：《广西医科大学学报》2016年第4期650-653,共4页Journal of Guangxi Medical University

摘　　要：目的:探讨枸橼酸咖啡因治疗极低体重早产儿呼吸暂停(AOP)的临床效果及对脑神经发育的影响。方法:选取2014年12月至2015年11月湖北省十堰市妇幼保健院新生儿科收治的44例AOP患儿作为研究对象,按随机数字表法分为观察组和对照组,每组各22例,观察组采用枸橼酸咖啡因治疗,对照组采用氨茶碱治疗。对比两组治疗效果及预后,治疗前、后血浆β-内啡肽水平、智力发育指数(MDI)、运动发育指数(PDI)及血糖、血气指标[动脉血氧分压(PaO2)、动脉血二氧化碳分压(PaCO2)及动脉血氧饱和度(SaO2)]等。结果:观察组患儿治疗24h、48h后的呼吸暂停发作次数、呼吸暂停消失时间、氧疗时间均显著低于对照组(P<0.05);治疗72h后观察组患儿的血浆β-内啡肽水平明显低于对照组(P<0.05);治疗前观察组与对照组患儿的MDI、PDI指数差异均无统计学意义(P>0.05);治疗3个月后观察组患儿的MDI、PDI指数显著高于对照组(P<0.05)。治疗前、治疗72h后,观察组与对照组的空腹血糖、PaO2、PaCO2、SaO2比较,差异均无统计学意义(P>0.05)。结论:枸橼酸咖啡因治疗极低出生体重AOP的临床疗效较好,且对患儿脑神经发育有促进作用,值得临床推广应用。Objective:To investigate the clinical effect of caffeine citrate on the treatment of apnea ofprematurity(AOP)in very low birth weight infants(VLOWI).Methods:44cases of VLOWI with AOP treated in our hospital from December 2014 to November 2015 were selected and randomly divided into the observation group and the control group(22cases in each group).The infants in the observation group were treated with caffeine citrate,and those in the control group were treated with aminophylline.The therapeutic effects and prognosis,as well as the plasma level ofβ-endorphin,mental development index(MDI),psychomotor development index(PDI),the blood gas and the blood glucose indexes pre-and posttreatment were compared between two groups.Results:At 24 hand 48hafter treatment,the apnea incidence,the duration of apnea and oxygen therapy of the infants in the observation group were significantly lower than those in the control group(P <0.05).There was no significant difference in pretreatment MDI and PDI between two groups(P >0.05).At 3months post-treatment,the MDI and PDI in the observation group were significantly higher than those in the control group(P <0.05).There were no significant differences in the fasting glucose,PaO2,PaCO2 and SaO2between two groups at pretreatment and 72 hafter treatment.Conclusion:Caffeine citrate has a clinical curative effect on the treatment of VLOWI with AOP,and could promote the development of brain.Therefore,it is recommended for clinical application.

关 键 词：枸橼酸咖啡因 极低出生体重 早产儿呼吸暂停 神经发育 

分 类 号：R722.6[医药卫生—儿科]