枸橼酸咖啡因在早产儿呼吸暂停中的临床应用及对肺功能改善作用研究

Clinical application of caffeine citrate in apnea of premature infants and its effect on improving pulmonary function

目的探讨枸橼酸咖啡因在早产儿呼吸暂停中的应用价值。方法选取我院呼吸暂停早产儿102例(2017年6月~2019年1月),随机数字表法分为研究组(n=51)与对照组(n=51)。常规治疗基础上对照组采取氨茶碱,研究组采取枸橼酸咖啡因。统计两组治疗情况、临床疗效、肺功能[呼吸频率(RR)、潮气量(TV)、每分通气量(MV)及25%、50%、75%潮气量时呼气流速(TEF25、TEF50、TEF75)]、血清胰岛素样生长因子结合蛋白-3(IGFBP-3)及饥饿激素水平、不良反应。结果 (1)治疗情况:研究组用氧时间、nCPAP通气时间、用药时间及有创通气时间短于对照组,呼吸暂停发生频率低于对照组(P<0.05);(2)临床疗效:研究组总有效率(94.12%)高于对照组(80.39%)(P<0.05);(3)肺功能:研究组停药后TV、MV及TEF25、TEF50、TEF75高于对照组(P<0.05),RR组间比较无显著差异(P>0.05);(4)IGFBP-3及饥饿激素:治疗后两组IGFBP-3较治疗前增高、饥饿激素较治疗前降低,且研究组IGFBP-3高于对照组、饥饿激素低于对照组(P<0.05);(5)不良反应:研究组不良反应发生率(9.80%)低于对照组(25.49%)(P<0.05)。结论采取枸橼酸咖啡因治疗早产儿呼吸暂停,可有效改善患儿治疗情况,促使其肺功能恢复,提升疾病治疗效果,并能调节血清IGFBP-3及饥饿激素含量,且不良反应发生率较低,具有安全性。

Objective To explore the application value of caffeine citrate in apnea of premature infants. Methods 102 premature infants with apnea in our hospital from June 2017 to January 2019 were randomly divided into the study group(n=51) and the control group(n=51). On the basis of routine treatment, aminophylline wasused in the control group and caffeine citrate was used in the study group. The followed items were analyzed,including treatment,clinical efficacy,pulmonary function [respiratory rate( RR),tidal volume( TV),ventilation volume per minute( MV) and expiratory flow( TEF25,TEF50,TEF75) at 25%,50% and 75% tidal volume],serum insulin-like growth factor binding protein-3( IGFBP-3),starvation hormone levels and adverse reactions. Results( 1) Treatment: The oxygen time,nC PAP ventilation time,medication time and invasive ventilation time of the study group were shorter than those of the control group,and the frequency of apnea was lower than that of the control group( P < 0. 05).( 2) Clinical efficacy: The total effective rate of the study group( 94. 12%) was higher than that of the control group( 80. 39%)( P < 0. 05).( 3) Pulmonary function: The value of TV,MV,TEF25,TEF50 and TEF75 in the study group were higher than those in the control group( P < 0. 05),but there was no significant difference between RR groups( P > 0. 05).( 4) IGFBP-3 and hunger hormone: After treatment,IGFBP-3 increased and hunger hormone decreased in the two groups,and IGFBP-3 in the study group was higher than that in the control group and hunger hormone was lower than that in the control group( P < 0. 05).( 5) Adverse reactions: The incidence of adverse reactions in the study group( 9. 80%) was lower than that in the control group( 25. 49%)( P < 0. 05). Conclusion Caffeine citrate can effectively improve the treatment of apnea in premature infants,promote the recovery of pulmonary function,improve the therapeutic effect of disease,and regulate the levels of serum IGFBP-3 and hunger hormone. The incidence of adverse reactions is low and it is safe.