不同剂量咖啡因治疗早产儿呼吸暂停的效果及对体重增长的影响  

Effect of different doses of caffeine in treating apnea of prematurity and its impact on weight gain

作　　者：涂秀英[1] 范娟[1] 王建辉[1] TU Xiuying;FAN Juan;WANG Jianhui(Department of Neonatology,Children′s Hospital of Chongqing Medical University/Ministry of Education Key Laboratory of Child Development and Disorders/National Clinical Research Center for Child Health and Disorders/Chongqing Key Laboratory of Pediatrics,Chongqing 400014,China)

机构地区：[1]重庆医科大学附属儿童医院新生儿科/儿童发育疾病研究教育部重点实验室/国家儿童健康与疾病临床医学研究中心/儿科学重庆市重点实验室,400014

出　　处：《重庆医学》2021年第10期1676-1679,共4页Chongqing medicine

基　　金：重庆市科委技术创新与应用示范一般项目(cstc2018jscx-msybX0071);重庆市科卫联合医学科研项目(2021MSXM119)。

摘　　要：目的比较不同剂量枸橼酸咖啡因在改善早产儿呼吸结局及存活率的差异,并评估不同剂量咖啡因对早产儿体重增长的影响。方法收集2018年1月至2020年1月在该院新生儿病房住院,曾使用枸橼酸咖啡因治疗早产儿呼吸暂停(AOP)的患儿共123例。根据咖啡因维持剂量分为常规剂量组(5 mg·kg^(-1)·d^(-1))和高剂量组(10 mg·kg^(-1)·d^(-1)),比较两组患儿在主要呼吸结局、存活率、住院期间平均每日体重增长及纠正胎龄6个月时体重增长的差异。结果两组患儿在有创和无创机械通气时间、AOP时间、持续用氧时间、支气管肺发育不良发生率及存活率方面比较,差异无统计学意义(P>0.05)。高剂量组住院期间每日平均体重增长小于常规剂量组(P<0.05)。两组患儿中均有极低出生体重儿平均每日体重增长高于低出生体重儿和超低出生体重儿(P<0.05)。纠正胎龄6个月时,高剂量组体重增长仍小于常规剂量组(P<0.05)。结论高剂量枸橼酸咖啡因相比于常规剂量不能额外改善呼吸结局及存活率,且对早产儿的体重增长带来负面影响。Objective To compare the difference of different doses of caffeine citrate in improving respiratory outcomes and survival rate in preterm infants,and to evaluate the effect of different doses of caffeine on the weight gain of preterm infants.Methods A total of 123 preterm infants admitted to the neonatal wards of this hospital from Jan.2018 to Jan.2020 were collected and received the caffeine citrate treatment for apnea of prematurity(AOP).The patients were divided into the common dose group(5 mg·kg^(-1)·d^(-1))and high-dose group(10 mg·kg^(-1)·d^(-1)).The main respiratory outcomes,survival rate,average daily weight gain during hospitalization,and weight gain at the correcting gestational age of 6 months were compared between the two groups.Results There was no statistical difference in the aspects of the duration of invasive and noninvasive ventilation,duration of AOP onset,duration of persistent oxygen supplement,incidence rate of bronchopulmonary dysplasia and survival rate between the two groups(P>0.05).Average daily weight gain during hospitalization in the high-dose group was smaller than that in the conventional dose group(P<0.05);meanwhile,the average daily weight gain of the very low birthweight infants was higher than that of the low birthweight infants and extremely low birthweight infants(P<0.05).At the correcting gestational age of 6 months,the weight gain of the high-dose group was still lower than that of the conventional dose group(P<0.05).Conclusion Compared to the conventional dose,high dose of caffeine citrate could not additionally improve the respiratory outcomes and survival rate,moreover could bring the negative effect on the weight gain in preterm infants.

关 键 词：咖啡因 剂量 早产儿呼吸暂停 疗效 体重增长 

分 类 号：R722.6[医药卫生—儿科]