早期应用枸橼酸咖啡因对早产儿支气管肺发育不良的预防作用及对其肺功能的影响

Preventive effect of early application of caffeine citrate on bronchopulmonary dysplasia and pulmonary function in premature infants

目的探讨早产儿出生后早期应用枸橼酸咖啡因对其支气管肺发育不良的预防作用及对其肺功能的影响.方法选取2017年10月至2018年6月郑州大学第三附属医院NICU收治的胎龄<32周、体质量<1500g的150例早产儿作为研究对象,根据随机对照原则,将其分为枸橼酸咖啡因组(76例)和对照组(74例).枸橼酸咖啡因组患儿在出生后72h内给予静脉应用枸橼酸咖啡因;对照组患儿给予灭菌注射用水,患儿出现呼吸暂停时给予氨茶碱治疗.统计两组早产儿支气管肺发育不良(BPD)的发病情况,对两组早产儿纠正胎龄40周时行潮气呼吸肺功能进行检测和比较.结果枸橼酸咖啡因组患儿BPD发生率和辅助通气时间低于对照组(P<0.05),患儿肺功能指标潮气量(TV)、达峰时间比(TPTE/TE)、达峰容积比(VPTE/VE)、25%潮气量时呼气流速(TEF25)、50%潮气量时呼气流速(TEF50)、75%潮气量时呼气流速(TEF75)均高于对照组(P均<0.05),RR低于对照组(P<0.05);两组早产儿其他并发症如早产儿视网膜病(ROP)、新生儿坏死性小肠结肠炎(NEC)、颅内出血(ICH)、脑室周围白质软化(PVL)、败血症等比较差异未见统计学意义(P>0.05).结论早期应用枸橼酸咖啡因可以降低早产儿BPD的发生率,缩短辅助通气时间,改善潮气呼吸肺功能.

Objective To investigate the preventive effect of early application of caffeine citrate on bronchopulmonary dysplasia(BPD)and the effect on lung function of preterm infants.Methods A total of 150 premature infants with gestational age<32 weeks and body weight<1 500 g admitted to NICU in the Third Affiliated Hospital of Zhengzhou University from October 2017 to June 2018 were selected as the study subjects.And they were diviede into caffeiene citrate group(76 cases)and control goup(74 cases)by principles of randomized controlled trial.Children in caffeine citrate group were given caffeine citrate intravenously within 72 hours after birth;children in control group were given sterilized water injection,and children with apnea were given aminophylline treatment.The incidence of BPD in preterm infants of the two groups was counted.The tidal breathing pulmonary function was measured and compared between the two groups at corrected gestational age of 40 weeks.Results The incidence of BPD and the time of ventilation in caffeine citrate group were lower than those in control group(P<0.05),the indexes of pulmonary function,such as tidal volume(TV),peak time ratio(TPTE/TE),peak volume ratio(VPTE/VE),expiratory velocity at 25%tidal volume(TEF25),expiratory velocity at 50%tidal volume(TEF50),and expiratory velocity at 75%tidal volume(TEF75)were higher than those of the control group(P all<0.05);there were no significant differences in other complications such as retinopathy of premature infants(ROP),neonatal necrotizing enterocolitis(NEC),intracranial hemorrhage(ICH),periventricular leukomalacia(PVL),sepsis between the two groups(P>0.05).Conclusions Early application of caffeine citrate can reduce the incidence of BPD in premature infants,shorten the time of assisted ventilation,and improve tidal respiratory and pulmonary function.