[1]朱　萍,李德亮,张伟业.枸橼酸咖啡因与氨茶碱治疗早产儿呼吸暂停疗效比较[J].新乡医学院学报,2021,38(1):066-69.[doi:10.7683/xxyxyxb.2021.01.014]
　ZHU Ping,LI Deliang,ZHANG Weiye.Comparison of the effect between caffeine citrate and aminophylline in the treatment of premature infants with apnea[J].Journal of Xinxiang Medical University,2021,38(1):066-69.[doi:10.7683/xxyxyxb.2021.01.014]
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枸橼酸咖啡因与氨茶碱治疗早产儿呼吸暂停疗效比较
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《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
38
期数:
2021年1
页码:
066-69
栏目:
临床研究
出版日期:
2021-01-05

文章信息/Info

Title:
Comparison of the effect between caffeine citrate and aminophylline in the treatment of premature infants with apnea
作者:
朱　萍; 李德亮; 张伟业
（南阳市中心医院新生儿重症监护科，河南　南阳　473000）
Author(s):
ZHU Ping; LI Deliang; ZHANG Weiye
(Neonatal Intensive Care Unit of Nanyang Central Hospital,Nanyang 473000,Henan Province,China)
关键词:
早产儿; 呼吸暂停; 枸橼酸咖啡因; 氨茶碱; β-内啡肽
Keywords:
premature infantsapneacaffeine citrateaminophyllineβ-endorphin
分类号:
R725.6
DOI:
10.7683/xxyxyxb.2021.01.014
文献标志码:
A
摘要:
目的　比较枸橼酸咖啡因与氨茶碱治疗早产儿呼吸暂停的临床效果。方法　选择南阳市中心医院2016年1月至2018年12月收治的150例呼吸暂停早产儿为研究对象，根据治疗方法将患儿分为观察组和对照组，每组75例。对照组患儿给予氨茶碱治疗，观察组患儿给予枸橼酸咖啡因治疗，疗程均为7 d。观察2组患儿治疗期间呼吸暂停发作次数和呼吸暂停持续时间，记录患儿氧疗时间和住院时间，并观察患儿支气管肺发育不良（BPD）、视网膜病变、颅内出血、脑白质损伤及坏死性小肠结肠炎等并发症发生情况；分别于治疗前和治疗后，采用放射免疫法检测2组患儿血浆β-内啡肽（β-EP）水平，并检测患儿动脉血氧分压（PaO2）、动脉血二氧化碳分压（PaCO2）。结果　观察组患儿呼吸暂停发作次数显著少于对照组，呼吸暂停持续时间、氧疗时间、住院时间显著短于对照组（P<0.05）。治疗前2组患儿血浆β-ep水平及pao>2、PaCO2比较差异无统计学意义（P>0.05）；2组患儿治疗后血浆β-EP水平、PaCO2显著低于治疗前，PaO2显著高于治疗前（P<0.05）；治疗后，观察组患儿血浆β-ep水平、paco>2显著低于对照组，PaO2显著高于对照组（PP<0.05），2组患儿视网膜病变、颅内出血及坏死性小肠结肠炎发生率比较差异无统计学意义（>P>0.05）。结论　氨茶碱和枸橼酸咖啡因治疗早产儿呼吸暂停均有一定的效果，但枸橼酸咖啡因在减少早产儿呼吸暂停发作次数和持续时间、改善患儿血气指标、降低BPD和脑白质损伤等并发症发生率方面优于氨茶碱。undefinedundefinedundefined
Abstract:
Objective　To compare the clinical effect of caffeine citrate and aminophylline in the treatment of premature infants with apnea.Methods　　A total of 150 premature infants with apnea treated in Nanyang Central Hospital from January 2016 to December 2018 were selected as the research subjects.The patients were divided into observation group and control group according to the treatment methods,with 75 cases in each group.The patients in the control group were treated with aminophylline,while the patients in the observation group were treated with caffeine citrate for 7 days.The number of apnea attack and apnea duration during treatment were observed,and the oxygen therapy time and hospitalization time of the premature infants in the two groups were recorded.The complications such as bronchopulmonary dysplasia (BPD),retinopathy,intracranial hemorrhage,white matter injury and necrotizing enterocolitis were observed.The plasma β-endorphin (β-EP) level of patients was measured by radioimmunoassay,and the partial pressure of oxygen in artery (PaO2) and partial pressure of carbon dioxide in artery (PaCO2) of patients were measured before and after treatment.Results　Compared with the control group,the number of apnea attack in the observation group was significantly reduced,and the time of apnea duration,the oxygen therapy time and the hospitalization time were significantly shorter (P<0.05).There was no significant difference in plasma β-EP level,PaO2 and PaCO2 between the two groups before treatment (P>0.05).Compared with before treatment,the plasma β-EP level and PaCO2 were significantly decreased,while the PaO2 was significantly increased after treatment in the two groups (P<0.05).After treatment,the plasma β-EP level and PaCO2 in the observation group were significantly lower than those in the control group,and the PaO2 in the observation group was significantly higher than that in the control group (P<0.05).The incidences of BPD,retinopathy,intracranial hemorrhage,brain white matter injury and necrotizing enterocolitis in the observation group were 9.33% (7/75),6.67% (5/75),13.33% (10/75),2.67% (2/75) and 6.67% (5/75),respectively.The incidences of BPD,retinopathy,intracranial hemorrhage,brain white matter injury and necrotizing enterocolitis in the control group were 24.00% (18/75),10.67% (8/75),20.00% (15/75),16.00% (12/75) and 9.33% (7/75),respectively.The incidences of BPD and white matter injury in the observation group were significantly lower than those in the control group (P<0.05).There was no significant difference in the incidences of retinopathy,intracranial hemorrhage and necrotizing enterocolitis between the two groups (P>0.05).Conclusion　The effect of aminophylline and caffeine citrate in the treatment of premature infants with apnea is certain.However,caffeine citrate is superior to aminophylline in the frequency and duration of apnea,improving the blood gas analysis indexes,and reducing the incidence of complications such as BPD and white matter injury.

参考文献/References:

［1］　孙雪丽，姜春明.早产儿呼吸暂停的研究进展［J］.国际儿科学杂志，2017，44（5）：348-351.
［2］　曲凯.早产儿呼吸暂停临床干预的研究进展［J］.中国临床研究，2015,28（3）：396-398.
［3］　周洁，吉玲，王新华，等.枸橼酸咖啡因治疗早产儿呼吸暂停疗效观察［J］.新乡医学院学报，2019，36（4）：323-326.
［4］　邵肖梅，叶鸿瑁，丘小汕.实用新生儿学［M］.4 版.北京：人民卫生出版社，2011：423-424.
［5］　秦怀雪，赵静，周敏，等.咖啡因联合氨茶碱治疗早产儿呼吸暂停的疗效观察［J］.现代药物与临床,2019,34(2):397-400.
［6］　BORSZEWSKA-KORNACKA M K,HOZEJOWSKI R,RUTKOWSKA M,et al.Shifting the boundaries for early caffeine initiation in neonatal practice:results of a prospective,multicenter study on very preterm infants with respiratory distress syndrome［J］.PLoS One,2017,12(12):e0189152.
［7］　张霄，张海涛，吕勇，等.不同维持剂量枸橼酸咖啡因治疗极低出生体重早产儿呼吸暂停的前瞻性随机对照研究［J］.中国当代儿科杂志，2019，21（6）：558-561.
［8］　杨泽凯，刘西洋，姜岑.氨茶碱与枸橼酸咖啡因治疗对呼吸暂停新生儿神经行为和后期神经发育的影响［J］.临床和实验医学杂志，2019，18（11）：1199-1202.
［9］　陈兰，刘玲，石碧珍，等.枸橼酸咖啡因治疗对低出生体重早产儿肺保护及安全性的临床分析［J］.贵州医药，2020，44（2）：236-238.
［10］　张慧娟.咖啡因防治早产儿支气管肺发育不良的研究进展［J］.国际儿科学杂志,2018,45（10）：743-746.
［11］　崔娜娜，娄丹.不同剂量咖啡因防治早产儿呼吸暂停的meta分析［J］.医学综述，2019，25（11）：2268-2274.
［12］　陈静，陈晓，龚放.不同维持剂量枸橼酸咖啡因治疗早产儿呼吸暂停疗效和安全性的meta分析［J］.临床儿科杂志，2018，36（9）：697-701.
［13］　纪小艺，吴敏，杨戎威，等.枸橼酸咖啡因与氨茶碱治疗早产儿原发性呼吸暂停临床疗效及对血β-内啡肽的影响［J］.浙江中西医结合杂志，2018，28（11）：954-957.
［14］　王昌燕.枸橼酸咖啡因与氨茶碱对早产儿神经行为发育影响分析［J］.中国儿童保健杂志，2019，27（4）：421-424.
［15］　黄会芝，胡晓峰，温晓红，等.枸橼酸咖啡因与氨茶碱治疗对呼吸暂停早产儿神经发育的影响［J］.中华实用儿科临床杂志，2018，33（2）：147-149.

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更新日期/Last Update: 2021-01-05