枸橼酸咖啡因对早产儿早期脑电活动的影响

Effects of caffeine on cerebral cortical activity in preterm infants

目的研究枸橼酸咖啡因对早产儿生后早期脑电活动的影响。方法选取2016年1月—2016年9月出生后即收治新生儿重症监护室,产时无窒息抢救史、出生胎龄28~34周的早产儿为研究对象,以住院期间未使用任何兴奋呼吸中枢药物的早产儿为正常对照组,以相同校正胎龄、住院期间规范使用过枸橼酸咖啡因治疗早产儿为咖啡因组。在咖啡因组早产儿停用枸橼酸咖啡因后,分别在校正胎龄33、34、35周行振幅整合脑电图(a EEG)检测,每次连续监测4 h,使用Burdjalov评分表对a EEG图像进行评价并分别测算暴发间期,分析枸橼酸咖啡因对于早产儿生后早期脑电活动的影响。结果共纳入49例早产儿,咖啡因组21例、对照组28例,男女比例1.45:1。在同一校正胎龄时,咖啡因组与对照组a EEG的Burdjalov评分总分及各单项评分的差异均无统计学意义(P>0.05);咖啡因组的暴发间期短于对照组,差异有统计学意义(P<0.05)。所有入选早产儿a EEG监测时均未见明显惊厥样电活动。结论枸橼酸咖啡因的使用对早产儿早期脑电活动有影响,可能加速了早产儿脑功能发育成熟。

ObjectiveTo investigate the effects of caffeine on cerebral cortical activity in preterm infants. MethodsThe preterm infants with 28-34 week gestational age and without asphyxia at birth were recruited as the subjects from January to September 2016. The infants who received conventional caffeine citrate were assigned to the caffeine group, while the infants with the same postmenstrual age did not receive any drugs that excite respiratory center were assigned to the control group. In the caffeine group, after the use of caffeine citrate stopped, the amplitude integration electroencephalogram （aEEG） recording were performed at 33, 34, 35 weeks of postmenstrual age. All the aEEG recordings were continuously monitored for at least 4 hours. The aEEG images were assessed by Burdjalov scoring system, and the interburst intervals were calculated. The effects of caffeine on preterm infants’ cerebral cortical activity in early life were analyzed. ResultsIn a total of 49 preterm infants recruited, 21 were in caffeine group and 28 in control group, and the ratio of male and female was 1.45：1. At the same postmenstrual age, the total score and individual scores of aEEG assessed by Burdjalov scoring system were not signifcantly different between caffeine group and control group. However, the length of interburst interval was signifcantly shorter in caffeine group than that in control group （P〈0.05）. All the recruited preterm infants had no seizure-like activity when the aEEG was monitored. ConclusionThe use of caffeine citrate has effects on EEG activity in early life of preterm infants, which may accelerate the brain maturation of preterm infants.