不同维持剂量枸橼酸咖啡因治疗早产儿呼吸暂停的疗效及对智力发育的影响  

Effects of Different Maintenance Doses of Caffeine Citrate on Apnea of Prematurity and Its Influence on Intelligence Development

作　　者：沈凌凌 张瑞彪 温金玲 SHEN Ling-Ling;ZHANG Rui-Biao;WEN Jin-Ling(Department of Neonatology,Third People's Hospital of Huizhou city,Huizhou 516000,China)

机构地区：[1]惠州市第三人民医院新生儿科,广东惠州516000

出　　处：《中国药物经济学》2022年第10期80-83,91,共5页China Journal of Pharmaceutical Economics

摘　　要：目的探讨不同维持剂量枸橼酸咖啡因治疗早产儿呼吸暂停(AOP)的疗效及对智力发育的影响。方法选取惠州市第三人民医院新生儿科2019年3月至2021年3月收治的AOP患儿60例作为研究对象,根据枸橼酸咖啡因维持剂量不同分为常规组与观察组,各30例。所有患儿进行首次剂量为20 mg/kg枸橼酸咖啡因静脉滴注20~30 min,24 h后,常规组采用枸橼酸咖啡因维持剂量5 mg/kg治疗,观察组采用枸橼酸咖啡因维持剂量10 mg/kg治疗,比较两组治疗后24 h、48h、72h呼吸暂停频次,治疗后症状消失时间、枸橼酸咖啡因使用时间、机械通气时间,治疗前后呼吸力学状态和智力发育指标,及治疗期间不良反应发生率。结果两组治疗后24 h、48 h、72 h呼吸暂停频次逐渐下降,且观察组治疗后24 h、48 h、72 h呼吸暂停频次明显低于常规组,差异有统计学意义(P<0.05)。观察组治疗后症状消失时间、枸橼酸咖啡因使用时间、机械通气时间明显短于常规组,差异有统计学意义(P<0.05)。两组治疗前25%潮气量时呼气流速(TEF25%)、50%潮气量时呼气流速(TEF50%)、潮气量(TV)、达峰时间比和各维度评分比较,差异无统计学意义(P>0.05);两组治疗后TEF25%、TEF50%、TV、达峰时间比和治疗后随访12个月各维度评分明显高于治疗前,且观察组治疗后TEF25%、TV、达峰时间比和治疗后随访12个月各维度评分明显高于常规组,差异有统计学意义(P<0.05);两组治疗后TEF50%比较,差异无统计学意义(P>0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论枸橼酸咖啡因维持剂量10 mg/kg治疗AOP可以有效改善患儿呼吸暂停频次及持续时间,缩短呼吸机使用时间,改善其呼吸力学状态和智力发育,且安全性较好。Objective To explore the efficacy of different maintenance doses of caffeine citrate on apnea of prematurity(AOP and its influence on intelligence development.Methods 60 children with AOP in the department of neonatology in the third people’s hospital of huizhou city from January 2019 to January 2021 were divided into two groups according to different maintenance dose of caffeine citrate,30 cases in each group.All children received the first dose of 20 mg/kg caffeine citrate by intravenous drip for 20~30 minutes.Then 24 hours later,the routine group was treated with caffeine citrate maintenance dose of 5 mg/kg,and the observation group was treated with caffeine citrate maintenance dose of 10 mg/kg.The apnea frequency of 24 h,48 h and 72 h after treatment,time of symptom disappearance,caffeine citrate use time,mechanical ventilation time,indexes of respiratory mechanics and intellectual development before and after treatment,and the incidence of adverse reactions during treatment were compared between the two groups.Results The frequency of apnea in the two groups decreased gradually at 24 h,48 h and 72 h after treatment,and the frequency of apnea at 24 h,48 h and 72 h after treatment,the time of symptom disappearance,caffeine citrate use time and mechanical ventilation time in the observation group was significantly lower than that in the conventional group(P<0.05).There was no significant difference in the 25%tidal volume during expiratory flow(TEF25%),the 50%tidal volume during expiratory flow(TEF50%),tidal volume(TV),peak time ratio and score of each dimension between the two groups before treatment(P>0.05).The TEF25%,TEF50%,TV,peak time ratio after treatment and score of each dimension at 12-month follow-up were significantly higher than those before treatment in both groups(P<0.05),and TEF25%,TV,peak time ratio after treatment and score of each dimension at 12-month follow-up in observation group were significantly higher than those in conventional group(P<0.05);there was no significant difference in TEF50

关 键 词：维持剂量 枸橼酸咖啡因 早产儿呼吸暂停 呼吸力学状态 智力发育 

分 类 号：R722.6[医药卫生—儿科] R985[医药卫生—临床医学]