布地奈德联合咖啡因预防早产儿支气管肺发育不良的疗效研究

Clinical efficacy of budesonide combined with caffeine citrate for preventing bronchopulmonary dysplasia in preterm infants

目的分析早期联合使用吸入性布地奈德和枸橼酸咖啡因预防极低出生体重早产儿支气管肺发育不良(BPD)的临床疗效,以期为BPD的防治提供参考。方法2014年10月-2017年10月在合肥市第一人民医院南区滨湖医院选取胎龄<32周且出生体重低于1500g的极低出生体重儿60例,随机分成咖啡因+布地奈德组(n=30例)和咖啡因组(n=30)。比较两组呼吸机使用时间、撤机后吸氧时间、住院时间、病死率、BPD发生率及常见并发症的发生率。结果咖啡因+布地奈德组呼吸机使用时间和吸氧时间明显短于咖啡因组(t=2.09,Z=2.36,P<0.05),咖啡因+布地奈德组的BPD发生率较咖啡因组有所降低,但差异无统计学意义(P>0.05),两组住院时间及常见并发症的发生率差异无统计学意义(P>0.05)。结论早期联合使用吸入性布地奈德和枸橼酸咖啡因能够有效缩短呼吸机使用及吸氧时间,在一定程度上降低了BPD的发生率。

Objective To explore the clinical efficacy of early inhaled budesonide combined with caffeine citrate for preventing bronchopulmonary dysplasia(BPD) in very low birth weight(VLBW) infants,in order to provide evidence for the prevention and treatment of BPD. Methods A total of 60 VLBW infants with gestational age under 32 weeks and weight under 1 500 g in Binhu Hospital of Southern District,the First Hospital of Hefei City were enrolled in this study from October 2014 to October 2017,and were randomly assigned into budesonide combined with caffeine group(n=30) and caffeine group(n=30).Duration of ventilation,duration of oxygen supplementation,duration of hospitalization,mortality,incidence of BPD and common complications between the two groups were compared. Results Compared with the caffeine group,budesonide combined with caffeine group had a shorter duration of ventilation and oxygen supplementation(t=2.09,Z=-2.36,P <0.05).The incidence of BPD in budesonide combined with caffeine group was lower than that in caffeine group,but the difference was not statistically significant(P>0.05).There were no significant differences on the duration of hospitalization and the incidence of other common complications between the two groups(P>0.05). Conclusion Early inhaled budesonide combined with caffeine citrate can effectively shorten the duration of ventilation and oxygen supplementation,and can reduce the incidence of BPD to some extent.