枸橼酸咖啡因辅助治疗对新生儿呼吸窘迫综合征患儿血清Clara细胞分泌蛋白、促肾上腺皮质激素和E选择素水平的影响

Effects of Caffeine Citrate Adjuvant Therapy on Levels of Serum Clara Cells Secreted Protein,Adrenocorticotropin Hormoneand E-Selectin in Neonates with Respiratory Distress Syndrome

目的:探讨枸橼酸咖啡因辅助治疗对新生儿呼吸窘迫综合征(NRDS)的疗效及血清Clara细胞分泌蛋白(CC16)、促肾上腺皮质激素(ACTH)及E选择素(CD62E)水平的影响。方法:选取2020年11月~2021年11月某院收治的76例NRDS患儿作为研究对象,采用随机数字表法分为观察组和对照组,每组38例。所有患儿进行常规药物治疗,对照组在常规治疗基础上给予机械通气治疗,观察组在对照组治疗基础上加用枸橼酸咖啡因。比较两组患儿氧动力学指标[动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))、吸入气氧浓度(FiO_(2))和PaO_(2)/FiO_(2)]、血清CC16、ACTH和CD62E水平、肺功能指标[第1秒用力呼气容积(FEV_(1))、用力肺活量(FVC)、FEV_(1)/FVC]、临床疗效及不良反应发生情况。结果:治疗后,两组患儿PaO_(2)和PaO_(2)/FiO_(2)较治疗前升高(P<0.05),且观察组高于对照组(P<0.05);PaCO_(2)较治疗前降低(P<0.05),且观察组低于对照组(P<0.05);血清CC16、ACTH和CD62E水平较治疗前降低(P<0.05),且观察组低于对照组(P<0.05);FEV_(1)和FEV_(1)/FVC较治疗前升高(P<0.05),且观察组高于对照组(P<0.05)。观察组临床总有效率(94.74%)高于对照组(78.95%,P<0.05)。观察组不良反应总发生率(7.89%)低于对照组(26.31%,P<0.05)。结论:在辅助呼吸治疗的基础上联用枸橼酸咖啡因可提高NRDS患儿的临床疗效,改善机体氧合状态和肺功能,降低血清CC16、ACTH及CD62E水平,且不良反应发生率较低。

Objective:To investigate the efficacy of adjunctive therapy with caffeine citrate in neonatal respiratory distress syndrome(NRDS)and its effect on serum Clara cell secretory protein(CC16),adrenocorticotropic hormone(ACTH)and E-selectin(CD62E).Methods:A total of 76 patients with NRDS admitted to our hospital during November 2020 to November 2021 were divided into control group and observation group by random number table,with 38 patients in each group.All the children were treated with conventional medication.In addition to the conventional adjuvant care,the control group was given mechanical ventilation,and the observation group was given caffeine citrate along with mechanical ventilation.The oxygen dynamics indexes[arterial partial pressure of oxygen(PaO_(2)),arterial partial pressure of carbon dioxide(PaCO_(2)),fractional concentration of inspired oxygen(FiO_(2))and PaO_(2)/FiO_(2)],serum CC16,ACTH and CD62E levels,and lung function indexes[forced expiratory volume in one second(FEV_(1)),forced vital capacity(FVC),FEV_(1)/FVC],clinical efficacy and occurrence of adverse reactions were compared between the two groups.Results:After treatment,PaO_(2)and PaO_(2)/FiO_(2)in both groups were increased than those before treatment(P<0.05),which were higher in the observation group than in the control group(P<0.05);PaCO_(2)was decreased in both groups than that before treatment(P<0.05),which was lower in the observation group than in the control group(P<0.05);the serum levels of CC16,ACTH and CD62E in both groups were reduced than those before treatment(P<0.05),which were lower in the observation group than those in the control group(P<0.05).FEV_(1)and FEV_(1)/FVC in both groups were increased than those before treatment(P<0.05),which were higher in the observation group than those in the control group(P<0.05).The total response rate of the observation group(94.74%)was higher than that of the control group(78.95%,P<0.05).The overall incidence of adverse reactions in the observation group(7.89%)was lower than that in the control group(26.31%,P<0.05).Conclusion:Caffeine citrate in combination with assisted ventilation can improve the clinical efficacy in NRDS children,improve the oxygenation and lung function,and reduce the serum levels of CC16,ACTH and CD62E,and the incidence of adverse reactions is low.