咖啡因对持续肺动脉高压新生儿血浆降钙素基因相关肽水平及肺动脉压力的影响

Effect of caffeine on plasma level of calcitonin gene-related peptide and pulmonary arterial pressure in persistent pulmonary hypertension of the newborn

目的探讨咖啡因对持续肺动脉高压(PPHN)新生儿血浆降钙素基因相关肽(CGRP)水平及肺动脉压力的影响。方法将52例PPHN患儿随机分为咖啡因治疗组及对照组各26例,对照组给予临床常规治疗,咖啡因组在常规治疗的基础上给予咖啡因静脉治疗,分别在用药前、用药第3天及第7天采集静脉血,用酶联免疫吸附剂测定法检测血浆CGRP水平,并通过彩色多普勒超声诊断仪测定其肺动脉压力。结果治疗后咖啡因组血浆CGRP水平明显高于对照组(P<0.05);咖啡因组血浆CGRP水平随着时间的延长而升高,对照组血浆CGRP水平随着时间的延长而降低(P<0.05)。治疗后咖啡因组肺动脉压力明显低于对照组(P<0.05);两组肺动脉压力有随着时间变化的趋势(P<0.05),其中咖啡因组的肺动脉压力随观察时间的延长而降低。结论咖啡因可能通过促进CGRP表达来达到降低肺动脉压力的效果,其可作为治疗PPHN的辅助药物。

Objective To explore the effect of caffeine on the plasma level of calcitonin gene-related peptide（CGRP） and pulmonary arterial pressure in persistent pulmonary hypertension of the newborn （PPHN）. Methods Fifty-two neonates with PPHN were randomly divided into caffeine group and control group,with 26 cases in each group. The control group received routine therapy,and the caffeine group was administered intravenously caffeine on the basis of routine therapy. Before treatment,on the 3rd and 7th day of treatment,the plasma level of CGRP was detected using enzyme-linked immunosorbent assay, and the pulmonary arterial pressure was measured by color Doppler ultrasound. Results The plasma level of CGRP in the caffeine group was significantly higher than that in the control group after treatment（P 〈0.05）. The plasma level of CGRP in the caffeine group increased over time, but the level in the control group decreased over time （P 〈 0. 05 ）. The pulmonary arterial pressure in the caffeine group was significantly lower than that in the control group after treatment （P 〈 0. 05）. The pulmonary arterial pressure of both groups tended to change over time （P 〈 0. 05）, and the pulmonary arterial pressure in the caffeine group decreased over time. Conclusion Caffeine may lower the pulmonary arterial pressure by promoting the expression of CGRP,and it can become the complementary medicine for PPHN.