枸橼酸咖啡因治疗胎龄28～32周早产儿呼吸暂停的临床观察
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摘要
目的:探究枸橼酸咖啡因治疗胎龄28~32周早产儿呼吸暂停(AOP)的临床疗效。方法:选取2015年11月-2017年11月本院收治的65例早产儿。按照治疗方案不同将其分为对照组32例和观察组33例。对照组使用枸橼酸咖啡因常规剂量,观察组使用枸橼酸咖啡因高剂量。比较两组心率、血压、呼吸暂停次数、用氧时间、住院时间及并发症情况。结果:观察组治疗后的呼吸暂停次数、用氧时间及住院时间分别为(1.0±0.2)次/d、(4.2±1.3)d及(28.6±2.8)d,均低于对照组的(1.5±0.3)次/d、(6.3±1.2)d及(35.6±3.2)d,比较差异均有统计学意义(P<0.05);观察组治疗后的心率、平均收缩压、平均舒张压分别为(128.57±10.33)次/min、(64.22±5.24)mm Hg及(45.27±2.95)mm Hg,明显高于对照组的(120.83±10.16)次/min、(61.13±4.15)mm Hg及(42.15±2.71)mm Hg,比较差异均有统计学意义(P<0.05);两组并发症发生率比较差异无统计学意义(P>0.05)。结论:枸橼酸咖啡因治疗胎龄28~32周AOP的临床疗效显著,可有效减少早产儿的呼吸暂停次数、用氧时间及住院时间,但患儿的心率加快,血压有所升高,并发症发生率未发生明显变化。
Objective:To explore the clinical efficacy of Caffeine Citrate in treatment of apnea of prematurity(AOP) with gestational age of 28-32 weeks.Method:A total of 65 premature infants admitted to our hospital from November 2015 to November 2017 were selected.According to different treatment regimens,they were divided into 32 cases of control group and 33 cases of observation group.The control group was given Caffeine Citrate regular dose,while observation group was given high dose Caffeine Citrate.The heart rate,blood pressure,apnea frequency,oxygen consumption time,hospitalization time and complications between two groups were compared.Result:After treatment,the apnea frequency,oxygen consumption time and hospitalization time in observation group were(1.0±0.2)times/d,(4.2±1.3) d and(28.6±2.8)d,were lower than(1.5±0.3)times/d,(6.3±1.2)d,(35.6±3.2)d in control group,the differences were statistically significant(P<0.05).After treatment,the heart rate,mean systolic blood pressure and mean diastolic blood pressure of observation group were(128.57±4.2)times/min,(64.22 ±5.24)mm Hg and(45.27±2.95) mm Hg,were significantly higher than(120.83±10.16)times/min,(61.13 ±4.15) mm Hg and(42.15±2.71) mm Hg in control group,the differences were statistically significant(P<0.05).The incidence of complications in two groups were compared,the differences were not statistically significant(P>0.05).Conclusion:The clinical efficacy of Caffeine Citrate in treatment of AOP with gestational age of 28-32 weeks is significant,it can effectively reduce the number of apnea,oxygen time and time of hospitalization in premature infants,but the heart rate of the children is quicker,the blood pressure is rised,and the incidence of complications has not changed obviously.
Objective:To explore the clinical efficacy of Caffeine Citrate in treatment of apnea of prematurity(AOP) with gestational age of 28-32 weeks.Method:A total of 65 premature infants admitted to our hospital from November 2015 to November 2017 were selected.According to different treatment regimens,they were divided into 32 cases of control group and 33 cases of observation group.The control group was given Caffeine Citrate regular dose,while observation group was given high dose Caffeine Citrate.The heart rate,blood pressure,apnea frequency,oxygen consumption time,hospitalization time and complications between two groups were compared.Result:After treatment,the apnea frequency,oxygen consumption time and hospitalization time in observation group were(1.0±0.2)times/d,(4.2±1.3) d and(28.6±2.8)d,were lower than(1.5±0.3)times/d,(6.3±1.2)d,(35.6±3.2)d in control group,the differences were statistically significant(P<0.05).After treatment,the heart rate,mean systolic blood pressure and mean diastolic blood pressure of observation group were(128.57±4.2)times/min,(64.22 ±5.24)mm Hg and(45.27±2.95) mm Hg,were significantly higher than(120.83±10.16)times/min,(61.13 ±4.15) mm Hg and(42.15±2.71) mm Hg in control group,the differences were statistically significant(P<0.05).The incidence of complications in two groups were compared,the differences were not statistically significant(P>0.05).Conclusion:The clinical efficacy of Caffeine Citrate in treatment of AOP with gestational age of 28-32 weeks is significant,it can effectively reduce the number of apnea,oxygen time and time of hospitalization in premature infants,but the heart rate of the children is quicker,the blood pressure is rised,and the incidence of complications has not changed obviously.
引文
[1]朱洪斌,高彩云,闫爱霞,等.nBiPAP和nCPAP治疗早产儿呼吸暂停疗效比较及对患儿肺功能和Gesell评分的影响[J].临床肺科杂志,2018,23(1):73-78.
[2]赵强,宋红,李志洁,等.枸橼酸咖啡因在早产儿原发性呼吸暂停中的临床研究[J].中国临床药理学杂志,2016,32(7):588-590.
[3]何舒婕,丁国芳.早产儿呼吸暂停的管理[J].中国新生儿科杂志,2015,30(2):155-158.
[4]杨伊琳.不同维持量枸橼酸咖啡因治疗早产儿呼吸暂停的效果比较[J].广东医学,2017,38(S1):246-248,250.
[5]郭玥馨,牛莉苹.枸橼酸咖啡因与氨茶碱联合纳洛酮治疗早产儿呼吸暂停临床效果[J].实用医学杂志,2016,32(5):819-821.
[6]Parikka V,Beck J,Zhai Q,et al.The effect of caffeine citrate on neural breathing pattern in preterm infants[J].Early Human Develop,2015,91(10):565-568.
[7]要丽君,范雪爱.枸橼酸咖啡因与湿化高流量鼻导管通气治疗早产儿呼吸暂停的疗效比较[J].安徽医学,2017,38(11):1452-1454.
[8]卢金淼,朱琳,李静,等.枸橼酸咖啡因在早产儿和足月新生儿中的药动学及其在呼吸暂停治疗中的应用进展[J].中国药学杂志,2017,52(21):1884-1888.
[9]Sanjay Kumar chaudhari,陈厚炎,谭举方,等.不同剂量枸橼酸咖啡因和氨茶碱治疗早产儿呼吸暂停的研究[J].中国新生儿科杂志,2016,31(5):348-352.
[10]高晓燕,奚碧冰,陈明娟,等.不同维持剂量枸橼酸咖啡因治疗早产儿呼吸暂停的临床效果比较[J].广西医学,2017,39(12):1808-1810,1826.
[11]王玲玲,温晓红,黄金华,等.枸橼酸咖啡因与氨茶碱治疗早产儿原发性呼吸暂停及对神经发育影响的比较[J].中国儿童保健杂志,2017,25(11):1176-1178.
[12]McPherson C,Neil J J,Tjoeng T H,et al.A pilot randomized trial of high-dose caffeine therapy in preterm infants[J].Pediatr Res,2015,78(2):198-204.
[13]刘枭,周彬,吴杰斌,等.枸橼酸咖啡因联合双水平正压通气治疗早产儿呼吸暂停疗效观察[J].儿科药学杂志,2017,23(11):14-17.
[14]曾云燕,杨林.枸橼酸咖啡因治疗早产儿呼吸暂停疗效分析[J].中国妇幼健康研究,2018,29(3):390-391.
[15]张连红.不同剂量咖啡因与不同体位干预治疗早产儿呼吸暂停的疗效观察[J].中国妇幼保健,2018,33(4):853-855.
[16]Mohammed S,Nour I,Shabaan A E,et al.High versus lowdose caffeine for apnea of prematurity:a randomized controlled trial[J].Eur J Pediatr,2015,174(7):949-956.
[17]李丽,周彬.高剂量与低剂量咖啡因治疗早产儿原发性呼吸暂停效果及安全性研究[J].中国全科医学,2017,20(35):4442-4446.
[18]朱洪斌,高彩云,闫爱霞,等.枸橼酸咖啡因联合正压通气治疗呼吸暂停早产儿的疗效及对血清饥饿激素、胰岛素样生长因子结合蛋白3的影响[J].中国妇幼保健,2018,33(3):595-598.
[19]Lista G,Fabbri L,Polackova R,et al.The Real-World Routine Use of Caffeine Citrate in Preterm Infants:A European Postauthorization Safety Study[J].Neonatology,2016,109(3):221-227.
[20]刘雅竹,陈亚丹,李婷婷,等.不同剂量枸橼酸咖啡因用于早产儿呼吸暂停的疗效和安全性系统评价[J].中国医院药学杂志,2018,38(2):173-178.
[21]黄珊华,林春繁,林艳,等.枸橼酸咖啡因与氨茶碱治疗早产儿原发性呼吸暂停的疗效对比[J].中国临床医生杂志,2018,46(3):359-361.
[2]赵强,宋红,李志洁,等.枸橼酸咖啡因在早产儿原发性呼吸暂停中的临床研究[J].中国临床药理学杂志,2016,32(7):588-590.
[3]何舒婕,丁国芳.早产儿呼吸暂停的管理[J].中国新生儿科杂志,2015,30(2):155-158.
[4]杨伊琳.不同维持量枸橼酸咖啡因治疗早产儿呼吸暂停的效果比较[J].广东医学,2017,38(S1):246-248,250.
[5]郭玥馨,牛莉苹.枸橼酸咖啡因与氨茶碱联合纳洛酮治疗早产儿呼吸暂停临床效果[J].实用医学杂志,2016,32(5):819-821.
[6]Parikka V,Beck J,Zhai Q,et al.The effect of caffeine citrate on neural breathing pattern in preterm infants[J].Early Human Develop,2015,91(10):565-568.
[7]要丽君,范雪爱.枸橼酸咖啡因与湿化高流量鼻导管通气治疗早产儿呼吸暂停的疗效比较[J].安徽医学,2017,38(11):1452-1454.
[8]卢金淼,朱琳,李静,等.枸橼酸咖啡因在早产儿和足月新生儿中的药动学及其在呼吸暂停治疗中的应用进展[J].中国药学杂志,2017,52(21):1884-1888.
[9]Sanjay Kumar chaudhari,陈厚炎,谭举方,等.不同剂量枸橼酸咖啡因和氨茶碱治疗早产儿呼吸暂停的研究[J].中国新生儿科杂志,2016,31(5):348-352.
[10]高晓燕,奚碧冰,陈明娟,等.不同维持剂量枸橼酸咖啡因治疗早产儿呼吸暂停的临床效果比较[J].广西医学,2017,39(12):1808-1810,1826.
[11]王玲玲,温晓红,黄金华,等.枸橼酸咖啡因与氨茶碱治疗早产儿原发性呼吸暂停及对神经发育影响的比较[J].中国儿童保健杂志,2017,25(11):1176-1178.
[12]McPherson C,Neil J J,Tjoeng T H,et al.A pilot randomized trial of high-dose caffeine therapy in preterm infants[J].Pediatr Res,2015,78(2):198-204.
[13]刘枭,周彬,吴杰斌,等.枸橼酸咖啡因联合双水平正压通气治疗早产儿呼吸暂停疗效观察[J].儿科药学杂志,2017,23(11):14-17.
[14]曾云燕,杨林.枸橼酸咖啡因治疗早产儿呼吸暂停疗效分析[J].中国妇幼健康研究,2018,29(3):390-391.
[15]张连红.不同剂量咖啡因与不同体位干预治疗早产儿呼吸暂停的疗效观察[J].中国妇幼保健,2018,33(4):853-855.
[16]Mohammed S,Nour I,Shabaan A E,et al.High versus lowdose caffeine for apnea of prematurity:a randomized controlled trial[J].Eur J Pediatr,2015,174(7):949-956.
[17]李丽,周彬.高剂量与低剂量咖啡因治疗早产儿原发性呼吸暂停效果及安全性研究[J].中国全科医学,2017,20(35):4442-4446.
[18]朱洪斌,高彩云,闫爱霞,等.枸橼酸咖啡因联合正压通气治疗呼吸暂停早产儿的疗效及对血清饥饿激素、胰岛素样生长因子结合蛋白3的影响[J].中国妇幼保健,2018,33(3):595-598.
[19]Lista G,Fabbri L,Polackova R,et al.The Real-World Routine Use of Caffeine Citrate in Preterm Infants:A European Postauthorization Safety Study[J].Neonatology,2016,109(3):221-227.
[20]刘雅竹,陈亚丹,李婷婷,等.不同剂量枸橼酸咖啡因用于早产儿呼吸暂停的疗效和安全性系统评价[J].中国医院药学杂志,2018,38(2):173-178.
[21]黄珊华,林春繁,林艳,等.枸橼酸咖啡因与氨茶碱治疗早产儿原发性呼吸暂停的疗效对比[J].中国临床医生杂志,2018,46(3):359-361.