不同维持剂量枸橼酸咖啡因对早产儿早期肺功能及并发症的影响  

EFFECT OF DIFFERENT MAINTENANCE DOSES OF CAFFEINE CITRATE ON EARLY-STAGE PULMONARY FUNCTION AND COMPLICATIONS IN PRETERM INFANTS

作　　者：郭永林 金蓉[3] 王青[3] 崔凤静[3] 刘冬云[3] GUO Yonglin;JIN Rong;WANG Qing;CUI Fengjing;LIU Dongyun(Faculty of Medicine,Qingdao University,Qingdao 266071,China)

机构地区：[1]青岛大学医学部,山东青岛266071 [2]菏泽市妇幼保健计划生育服务中心 [3]青岛大学附属医院综合儿科

出　　处：《精准医学杂志》2023年第1期9-13,共5页Journal of Precision Medicine

基　　金：国家自然科学基金资助项目(81701587);山东省医药卫生科技发展计划(2017WSB26008)。

摘　　要：目的探讨不同维持剂量的枸橼酸咖啡因治疗对早产儿早期肺功能及并发症的影响。方法选择2019年4月—2022年1月我院收治的出生胎龄28~33+6周、生后无需气管插管有创机械通气的早产儿78例作为研究对象,按照随机数字表法分为枸橼酸咖啡因高维持剂量组(40例)和枸橼酸咖啡因低维持剂量组(38例)。两组早产儿均在生后2 h给予枸橼酸咖啡因20 mg/(kg·d)负荷量外周静脉泵入,24 h后高、低维持剂量组分别给予10、5 mg/(kg·d)维持剂量治疗。比较两组早产儿生后第7、14天及矫正胎龄40周时肺功能及并发症(新生儿坏死性小肠结肠炎、早产儿视网膜病变、脑室内出血)和不良反应(喂养不耐受、高血糖、心动过速)发生率。结果高维持剂量组早产儿生后第7、14天及矫正胎龄40周时的潮气量、达峰时间比、达峰容积比,以及生后第7、14天的呼吸频率均显著高于低维持剂量组(t=2.107~4.128,P<0.05)。高、低维持剂量组早产儿的并发症和不良反应的发生比例比较无明显差异(P>0.05)。结论高维持剂量的枸橼酸咖啡因改善早产儿早期肺功能的作用显著,且未增加相关并发症及不良反应。Objective To investigate the effect of different maintenance doses of caffeine citrate treatment on early-stage pulmonary function and complications in preterm infants.Methods A total of 78 preterm infants with a gestational age of 28 weeks to 33+6 weeks who were admitted to our hospital from April 2019 to January 2022 and did not need invasive mechanical ventilation after birth were enrolled as subjects,and they were divided into high-maintenance-dose caffeine citrate group with 40 infants and low-maintenance-dose caffeine citrate group with 38 infants using a random number table.Both groups were given peripheral intravenous pumping of caffeine citrate at a loading dose of 20 mg/(kg·d)at 2 h after birth,and then the high and low maintenance dose groups were given caffeine citrate at a maintenance dose of 10 mg/(kg·d)and 5 mg/(kg·d),respectively,after 24 h.The two groups were compared in terms of pulmonary function,complications(necrotizing enterocolitis,retinopathy of prematurity,and intraventricular hemorrhage),and adverse reactions(feeding intolerance,hyperglycemia,and tachycardia)on days 7 and 14 after birth and at the corrected gestational age of 40 weeks.Results Compared with the low maintenance dose group,the high maintenance dose group had significantly higher tidal volume,ratio of time to peak tidal expiratory flow to total expiratory time,and ratio of volume to peak tidal expiratory flow to total expiratory volume on days 7 and 14 after birth and at the corrected gestational age of 40 weeks,as well as a significantly higher respiratory rate on days 7 and 14 after birth(t=2.107-4.128,P<0.05).There were no significant differences in the incidence rates of complications and adverse reactions between the high and low maintenance dose groups(P>0.05).Conclusion A high maintenance dose of caffeine citrate can significantly improve early-stage pulmonary function in preterm infants without increasing related complications and adverse reactions.

关 键 词：柠檬酸盐类 咖啡因 呼吸功能试验 婴儿 早产 疾病 药物相关性副作用和不良反应 

分 类 号：R722.6[医药卫生—儿科] R443.6[医药卫生—临床医学]