枸橼酸咖啡因治疗对呼吸暂停早产儿早期肺功能的影响

Effect of caffeine citrate on early pulmonary function in preterm infants with apnea

目的探讨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。方法 40例AOP患儿随机分为氨茶碱治疗组(20例)和咖啡因治疗组(20例)。2组患儿均在生后出现呼吸暂停时在经鼻持续气道正压通气(NCPAP)辅助通气的基础上给予氨茶碱或枸橼酸咖啡因治疗,停药后行肺功能检测,比较两组之间肺功能的变化。结果治疗后咖啡因治疗组潮气量、每分通气量、达峰时间比、达峰容积比、潮气呼吸呼气峰流速及75%、50%、25%潮气量时呼吸流速均高于氨茶碱治疗组(P<0.05);咖啡因治疗组用氧时间、NCPAP使用时间均低于氨茶碱治疗组(P<0.01)。与氨茶碱治疗组比较,咖啡因治疗组用药7d后呼吸暂停发生频率明显减少(P<0.01)。结论枸橼酸咖啡因治疗AOP可以改善患儿早期肺功能,减少呼吸暂停的发生。

Objective To investigate the effect of caffeine citrate treatment on early pulmonary function in preterm infants with apnea. Methods Forty preterm infants with apnea were randomly divided into aminophylline treatment group（20 infants） and caffeine citrate treatment group（20 infants）. When the preterm infants experienced apnea after birth, they were given aminophylline or caffeine citrate in addition to assisted ventilation with continuous positive airway pressure（NCPAP）. After drug discontinuation, pulmonary function was measured and compared between the two groups. Results After treatment, compared with the aminophylline treatment group, the caffeine citrate treatment group had significantly higher tidal volume, minute ventilation volume, ratio of time to peak tidal expiratory flow to total expiratory time, ratio of volume to peak tidal expiratory flow to total expiratory volume, peak expiratory flow, and breathing flow at 75%, 50%, and 25% of tidal volume（P〈0.05）. The caffeine citrate treatment group had a significantly shorter time of oxygen use and NCPAP support than the aminophylline treatment group（P〈0.01）. Compared with the aminophylline treatment group, the caffeine citrate treatment group had a significantly lower frequency of apnea attacks（P〈0.01）. Conclusions In the treatment of apnea in preterm infants, caffeine citrate can improve early pulmonary function and reduce the incidence of apnea.