枸橼酸咖啡因注射液联合猪肺磷脂注射液治疗新生儿呼吸窘迫综合征的临床研究  

Clinical trial of caffeine citrate injection combined with poractant alfa injection in neonatal respiratory distress syndrome

作　　者：陈艳艳 钱元原 许冬梅 张小华[1] CHEN Yan-yan;QIAN Yuan-yuan;XU Dong-mei;ZHANG Xiao-hua(Department of Pediatrics,Affiliated Maternity and Child Health Care Hospital of Nantong University,Nantong 226000,Jiangsu Province,China)

机构地区：[1]南通大学附属妇幼保健院儿内科,江苏南通226000

出　　处：《中国临床药理学杂志》2023年第8期1067-1071,共5页The Chinese Journal of Clinical Pharmacology

摘　　要：目的观察枸橼酸咖啡因注射液联合猪肺磷脂注射液治疗新生儿呼吸窘迫综合征的临床疗效及其对血气指标和预后的影响。方法将新生儿呼吸窘迫综合征患儿随机分为对照组和试验组。对照组给予猪肺磷脂注射液1.25 mL·kg^(-1),每天2次,经气管插管一次性滴入。试验组在对照组的基础上给予枸橼酸咖啡因注射液20 mg·kg^(-1)·d^(-1),静脉滴注30 min,24 h后给予维持量5~10 mg·kg^(-1)·d^(-1),2组均治疗7 d,观察28 d。比较2组临床疗效、预后情况、临床症状改善情况、心肌损伤指标、氧化应激指标、血气指标及安全性。结果对照组48例,试验组50例。治疗后,试验组与对照组总有效率分别为92.00%和77.08%,差异有统计学意义(P<0.05);试验组和对照组治疗后28 d存活率分别为96.00%和95.83%,差异无统计学意义(P>0.05)。试验组和对照组的上机时间分别为(83.10±6.97)和(95.41±8.59)h,用氧治疗时间分别为(81.41±7.94)和(98.73±9.68)h,呼吸暂停次数分别为(5.44±1.72)和(7.63±2.10)次,达到症状缓解时间分别为(25.75±3.10)和(32.61±4.06)h,住院时间分别为(16.48±2.64)和(21.93±3.82)d,差异均有统计学意义(均P<0.05)。治疗后,试验组和对照组患儿血清肌酸激酶同工酶(CK-MB)水平分别为(22.58±2.63)和(44.63±5.07)U·L-1,血清乳酸脱氢酶(LDH)水平分别为(277.50±39.51)和(352.61±48.65)U·L-1,血清超氧化物歧化酶(SOD)水平分别为(28.69±6.06)和(23.51±5.03)U·mL-1,血清丙二醛(MDA)水平分别为(21.52±3.52)和(37.62±4.28)μmol·L-1,氧分压(PaO_(2))分别为(84.04±8.10)和(73.27±6.94)mmHg,二氧化碳分压(PaCO_(2))分别为(40.04±4.10)和(45.73±4.83)mmHg,吸氧分数(FiO_(2))分别为(0.52±0.06)%和(0.68±0.09)%,PaO_(2)/FiO_(2)分别为(161.62±16.87)和(107.75±10.52)mmHg,差异均有统计学意义(均P<0.05)。治疗期间,试验组和对照组的总药物不良反应发生率分别为6.00%和10.42%,差异无统计学意义(P>0.05)。结论枸橼酸�Objective To analyze the clinical efficacy of caffeine citrate injection combined with poractant alfa injection and effect on blood gas indexes and prognosis of neonatal respiratory distress syndrome.Methods Children with neonatal respiratory distress syndrome were divided into control group and treatment group randomly.Control group was treated with poractant alfa injection 1.25 mL·kg^(-1),twice a day,injected once through endotracheal intubation.Treatment group was treated with caffeine citrate injection 20 mg·kg^(-1)·d^(-1),intravenous infusion for 30 min,after 24 h given a maintenance dose of 5-10 mg·kg^(-1)·d^(-1),on the basis of control group.Both groups were treated for 7 d,and then observed for 28 d.Results There were 48 cases in control group and 50 cases in treatment group.After treatment,the total effective rates of treatment group and control group were 92.00%and 77.08%,with statistical difference(P<0.05).The 28 d survival rates of treatment group and control group were 96.00%and 95.83%,without significant difference between the two groups(P>0.05).The cumulative operation time in treatment group and control group were(83.10±6.97)and(95.41±8.59)h;duration of treatment with oxygen were(81.41±7.94)and(98.73±9.68)h;number of apnea were(5.44±1.72)and(7.63±2.10)time;the time to symptom relief were(25.75±3.10)and(32.61±4.06)h;hospital stays were(16.48±2.64)and(21.93±3.82)d,the difference between the two groups were statistically significant(all P<0.05).After treatment,the levels of serum creatine kinase isoenzyme(CK-MB)in treatment group and control group were(22.58±2.63)and(44.63±5.07)U·L^(-1);the levels of serum lactate dehydrogenase(LDH)were(277.50±39.51)and(352.61±48.65)U·L^(-1);the levels of serum superoxide dismutase(SOD)were(28.69±6.06)and(23.51±5.03)U·mL^(-1);the levels of serum malondialdehyde(MDA)were(21.52±3.52)and(37.62±4.28)μmol·L^(-1);partial pressures of oxygen(PaO_(2))were(84.04±8.10)and(73.27±6.94)mmHg;partial pressures of carbon dioxide(PaCO_(2))were(40.04±4.1

关 键 词：枸橼酸咖啡因注射液 猪肺磷脂注射液 新生儿呼吸窘迫综合征 血气指标 预后 

分 类 号：R97[医药卫生—药品]