不同维持剂量枸橼酸咖啡因对极早产儿呼吸暂停治疗效果和早期脑电活动的影响

Effect of different maintenance doses of Caffeine Citrate on the treatment of apnea and the early-stage brain electrical activities among very preterm infants with primary apnea

目的探讨不同维持剂量的枸橼酸咖啡因对极早产儿原发性呼吸暂停(AOP)的治疗效果及早期脑电活动的影响。方法选取2018年1月至2019年12月福建省立医院收治的56例AOP患儿作为研究对象,按照随机数字表法将其分为观察组与对照组,每组各28例。两组患儿均给予常规处理联合枸橼酸咖啡因治疗,观察组患儿的咖啡因维持量为10 mg/(kg·d),对照组患儿为5 mg/(kg·d),两组患儿均在呼吸暂停症状消失7 d后停药。比较两组患儿的治疗效果、不良反应及并发症发生情况、振幅整合脑电图(aEEG)成熟度评分。结果观察组患儿治疗48 h后的呼吸暂停发作次数少于对照组,机械通气时间、吸氧时间、咖啡因治疗时间短于对照组,校正胎龄34、36、40周的aEEG成熟度评分高于对照组,差异有统计学意义(P<0.05)。两组患儿的不良反应总发生率和并发症总发生率比较,差异无统计学意义(P>0.05)。结论枸橼酸咖啡因维持剂量为10 mg/(kg·d)能够更好地缓解极早产儿原发性呼吸暂停症状,促进脑电活动的成熟,不良反应和并发症的发生率无明显增加。

Objective To investigate the effect of different maintenance doses of Caffeine Citrate on the treatment of apnea and the early-stage brain electrical activities among very preterm infants with primary apnea.Methods A total of 56 cases of very preterm infants with primary apnea and administered by Fujian Provincial Hospital from January 2018 to December 2019 were selected as the research objects and divided into the observation group and the control group by random number table method,with 28 cases in each group.The two groups both received the conventional treatment combined with the caffeine citrate treatment.The maintenance dose of Caffeine Citrate was 10 mg/(kg·d)for the observation group and 5 mg/(kg·d)for the control group.Both groups were suspended from taking the drug after symptoms of apnea disappeared for seven days.The treatment effect,adverse reactions and complications,and amplitude integrated electroencephalogram(aEEG)maturity score were compared between the two groups.Results After 48 h of treatment,the number of apnea attacks in the observation group was less than that in the control group,the duration of mechanical ventilation,oxygen inhalation and caffeine treatment were shorter than those in the control group,and the aEEG maturity score adjusted for gestational age of 34,36 and 40 weeks were higher than those in the control group,and the differences were statistically significant(P<0.05).There were no statistically significant differences in the total incidence of adverse reactions and complications between the two groups(P>0.05).Conclusion When the maintenance dose of caffeine citrate was 10 mg/(kg·d),the primary apnea symptoms of very preterm infants could be better alleviated,the maturity of brain electrical activities could be promoted,and the occurrence rate of adverse reactions and complications demonstrated no obvious increase.