咖啡因联合氨茶碱对呼吸暂停极低出生体质量儿相关血清学指标及预后的影响
摘要
目的分析咖啡因联合氨茶碱对呼吸暂停极低出生体质量儿相关血清学指标及预后的影响。方法选择2015年6月-2017年6月于佛山市第一人民医院新生儿科就诊的119例极低出生体质量儿为研究对象,按照随机数字表将患儿分为观察组(58例)及对照组(61例)。对照组患儿在常规治疗及经鼻持续气道正压通气(NCPAP)基础上给予氨茶碱注射液治疗,观察组患儿在此基础上给予枸橼酸咖啡因注射液治疗,比较两组患儿的治疗效果、预后、血气分析检测指标、血浆β-内啡肽(β-EP)水平、不良反应发生率。结果两组患儿治疗有效率比较,差异有统计学意义(χ~2=7. 947 6,P<0. 05)。观察组患儿用药时间及呼吸暂停症状消失时间均明显短于对照组(均P<0. 05)。两组患儿治疗前血气分析检测结果比较差异均无统计学意义(均P>0. 05)。治疗后,两组患儿血气分析检测结果均有一定改善,PaCO_2明显降低,PaO_2明显升高,且观察组患儿改善效果更显著(均P<0. 05)。两组患儿治疗前血浆β-EP水平比较差异无统计学意义(P>0. 05)。治疗后,两组患儿血浆β-EP水平均下降,且观察组变化更明显(均P<0. 05)。两组患儿不良反应发生率比较差异有统计学意义(P<0. 05)。结论咖啡因联合氨茶碱改善呼吸暂停极低出生体质量儿的临床效果显著,预后较好,且不良反应少,安全性高。
引文
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[2]孔玉显,张敬芳.枸橼酸咖啡因治疗早产儿呼吸暂停的临床疗效与安全性分析[J].医学理论与实践,2017,30(19):2912-2913.
[3]雷贤明,胡敏,刘佳,等.枸橼酸咖啡因防治极低出生体重儿呼吸暂停临床分析[J].中外医学研究,2017,15(20):31-33.
[4]李才荣,李婷,王玮琳,等.枸橼酸咖啡因早期治疗对早产呼吸暂停患儿肺功能的影响及安全性评价[J].中国药业,2017,26(1):59-61.
[5]郑丽文,陈泽钦.枸橼酸咖啡因治疗早产儿呼吸暂停(AOP)对患儿早期肺功能的影响探讨[J].齐齐哈尔医学院学报,2016,37(25):3182-3183.
[6]何焱志,黄梅.枸橼酸咖啡因治疗极低出生体重早产儿呼吸暂停的临床研究[J].广西医科大学学报,2016,33(4):650-653.
[7]赵剑锋,李俊燕.枸橼酸咖啡因防治极低出生体重儿呼吸暂停的临床研究[J].食品与药品,2016,18(2):133-135.
[8]Schmidt B,Roberts RS,Anderson PJ,et al.Academic performance,motor function,and behavior 11 years after neonatal caffeine citrate therapy for apnea of prematurity:an 11-year follow-up of the CAP randomized clinical trial[J].JAMA Pediatr,2017,171(6):564-572.
[9]于梅,黄金华,朱蓉,等.枸橼酸咖啡因治疗对呼吸暂停早产儿早期肺功能的影响[J].中国当代儿科杂志,2016,18(3):206-210.
[10]Schmidt B,Roberts RS,Davis PG,et al.Prediction of late death or disability at age 5 years using a count of 3 neonatal morbidities in very low birth weight infants[J].J Pediatr,2015,167(5):982-986.e2.
[11]沈珍珍,文革生.枸橼酸咖啡因防治极低出生体重儿呼吸暂停的疗效研究[J].中国儿童保健杂志,2016,24(2):207-210.
[12]Armanian AM,Iranpour R,Faghihian E,et al.Caffeine administration to prevent apnea in very premature infants[J].Pediatr Neonatol,2016,57(5):408-412.
[13]Clark MT,Delos JB,Lake DE,et al.Stochastic modeling of central apnea events in preterm infants[J].Physiol Meas,2016,37(4):463-484.
[14]吴春艳.枸橼酸咖啡因治疗早产低出生体重儿呼吸暂停综合征的临床疗效[J].宁夏医科大学学报,2015,37(12):1447-1450.
[15]陈烨,蒋琦,邓庆先.枸橼酸咖啡因在早产儿呼吸暂停治疗中的临床价值[J].妇幼医学,2015,53(34):55-57,60.
[16]吴春艳,王晓娇,王媛媛.枸椽酸咖啡因对新生儿呼吸暂停血气指标的影响[J].海南医学院学报,2015,21(11):1539-1541.
[17]Veit L,Amberson M,Freiberger C,et al.Diagnostic evaluation and home monitor use in late preterm to term infants with apnea,bradycardia,and desaturations[J].Clin Pediatr(Phila),2016,55(13):1210-1218.
[18]Cotton MF,Holgate S,Nelson A,et al.The last and first frontieremerging challenges for HIV treatment and prevention in the first week of life with emphasis on premature and low birth weight infants[J].J Int AIDS Soc,2015,18(7 Suppl 6):20271.
[19]Tey SL,Lee WT,Lee PL,et al.Neurodevelopmental outcomes in very low birth weight infants using aminophylline for the treatment of apnea[J].Pediatr Neonatol,2016,57(1):41-46.
[20]杨杰,舒蕾,杨秀玲,等.极低出生体重儿85例临床分析[J].云南医药,2017,38(2):129-132.