枸橼酸咖啡因联合肺泡表面活性物质治疗新生儿呼吸窘迫综合征的疗效及对血清BMP-7、CC16、SF水平的影响

Curative Efficacy of Caffeine Citrate is Combined with Alveolar Surface Active Material in Treatment of Neonatal Respiratory Distress Syndrome and Its Effects on Serum BMP-7, CC16 and SF

目的:探讨枸橼酸咖啡因联合肺泡表面活性物质治疗新生儿呼吸窘迫综合征患儿的疗效及对血清骨形态发生蛋白-7(BMP-7)、Clara细胞分泌蛋白(CC16)、铁蛋白(SF)水平的影响。方法:选择2016年3月到2018年3月我院接诊的新生儿呼吸窘迫综合征患儿90例作为研究对象,以随机数表法分为观察组(n=48)和对照组(n=42)。对照组使用肺泡表面活性物质进行治疗,观察组在对照组的基础上加用枸橼酸咖啡因进行治疗。比较两组治疗后的疗效,治疗前后血清BMP-7、CC16、SF水平、血气指标[氢离子浓度指数(p H)、二氧化碳分压(PCO2)、氧合指数(PaO2/Fi O2)]的变化,通气时间及支气管肺发育不良(BPD)的发生率。结果:治疗后,观察组总有效率为95.83%,明显高于对照组(71.43%,P<0.05);两组患儿血清BMP-7、CC16、SF水平较治疗前均显著降低(P<0.05),且观察组以上指标均明显低于对照组(P<0.05);两组患儿pH、PaO2/Fi O2均较治疗前明显升高,而PCO2较治疗前显著降低(P<0.05),且观察组患儿p H、PaO2/Fi O2显著高于对照组,而PCO2明显低于对照组(P<0.05)。观察组患儿通气时间明显短于对照组,BPD发生率显著低于对照组(P<0.05)。结论:枸橼酸咖啡因联合肺泡表面活性物质治疗新生儿呼吸窘迫综合征的临床效果显著优于单用肺泡表面活性物质治疗,其可有效改善患儿血清BMP-7、CC16、SF水平、缩短机械通气时间,降低支气管肺发育不良发生率。

Objective: To study the curative efficacy of caffeine citrate combined with alveolar surface active material in the treatment of neonatal respiratory distress syndrome and its effect on the serum Bone morphogenetic protein-7(bmp-7), Protein excreted by Clara cells(CC16) and Ferritin(SF) levels. Methods: 90 cases of patients with neonatal respiratory distress syndrome treated in our hospital from March 2016 to March 2018 were selected and randomized into the observation group(n=48) and the control group(n=42). The control group was treated with pulmonary surfactant, while the observation group was treated with caffeine citrate on the basis of the control group. After treatment, the changes of serum BMP-7, CC16, SF, blood gas index(pH, PCO2, PaO2), ventilation time and incidence of bronchopulmonary dysplasia(BPD) were compared between the two groups. Results: After treatment, the total effective rate of observation group was 95.83%, which was significantly higher than that of the control group(71.43%, P<0.05);the serum BMP-7, CC16, SF levels of both groups were significantly lower than those before treatment(P<0.05), and the above indicators of observation group were significantly lower than those of the control group(P<0.05);the p H, PaO2/FiO2 of both groups were significantly higher than those before treatment, while the PCO2 was significantly lower than before treatment(P<0.05), which was significantly lower than those before treatment(P<0.05), the pH, PaO2/FiO2 were significantly higher than those in the control group, while PCO2 was significantly lower than those in the control group(P<0.05). The ventilation time of the observation group was significantly shorter than that of the control group, and the incidence of BPD was significantly lower than that of the control group(P<0.05). Conclusion: The clinical effect of caffeine citrate combined with alveolar surfactant is significantly better than alveolar surfactant alone in the treatment of neonatal respiratory distress syndrome. It can effectively improve the serum BMP-7, CC16, SF levels, shorten the mechanical ventilation time and reduce the incidence of bronchopulmonary dysplasia.