Objectives To investigate the influence of caffeine citrate on early pulmonary function and intellectual development of premature infants with apnea of prematurity (AOP). Methods A total of 160 infants with primary AOP were enrolled in this study from January 2016 to January 2017,and were randomly divided into observation group (n=80) and control group (n=80). The control group was treated with aminophylline,while the observation group was given citrate caffeine. The treatment situation and complications were compared between the two groups. The early pulmonary function parameters,serum levels of IGFBP-3 and β-EP were measured after treatment,the Gesell Development Scale(GDS) score were compared at corrected age 6 and 12 months. Results The positive pressure ventilation time and total oxygen inhalation time in the observation group were significantly shorter than those in control group,and the apnea episodes at 24,48 and 72 hours after treatment in observation group were significantly lower than that of control group (P<0.05). After treatment,there were no significant differences on respiratory rate (RR) and respiration ratio between the two groups (P>0.05),but the minute ventilation (MV),tidal volume (VT),peak-to-peak time ratio (TPTEF/TE),peak-to-peak volume ratio (VPEF/VE),tidal breathing expiratory flow rate (PEF),tidal volume 25%,50%,75% exhalation flow rate (TEF25,TEF50,and TEF75) in observation group were significantly higher than those in control group (P<0.05). After treatment,the serum level of GFBP-3 in observation group was significantly higher than that in control group,while β-EP was significantly lower in observation group (P<0.05). The total complication rate in the observation group was significantly lower than that in control group (21.25% vs. 43.75%,P<0.05). The Gesell scores at 6,12 months of corrected age in the observation group were significantly higher than those in control group (P<0.05). Conclusion Citrate caffeine adjuvant therapy for primary AOP in premature infants can protect pulmonary function and neurological function,promote intelliectual development,and reduce complications.
Key words
apnea /
premature infants /
citrate caffeine /
pulmonary function /
intelligent development
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References
[1] 邵肖梅,叶鸿瑁,丘小汕.实用新生儿学[M].4版.北京:人民卫生出版社,2011:245-247.
[2] 李丽,周彬.高剂量与低剂量咖啡因治疗早产儿原发性呼吸暂停效果及安全性研究[J].中国全科医学,2017,20(35):4442-4446.
[3] 刘雅竹,陈亚丹,李婷婷,等.不同剂量枸橼酸咖啡因用于早产儿呼吸暂停的疗效和安全性系统评价[J]. 中国医院药学杂志,2018,38(2):173-178.
[4] 何焱志,黄梅.枸橼酸咖啡因治疗极低出生体重早产儿呼吸暂停的临床研究[J].广西医科大学学报,2016,33 (4) :650-653.
[5] 张磊,高瑛,孙建伟,等.枸橼酸咖啡因与氨茶碱治疗早产儿原发性呼吸暂停疗效分析[J].中华实用诊断与治疗杂志,2016,30(8):789-791.
[6] 柯华,李占魁,郭金珍,等.枸橼酸咖啡因与氨茶碱治疗早产儿原发性呼吸暂停疗效及并发症的研究[J]. 中国小儿急救医学,2017,24(1):56-59.
[7] 吴春艳.枸橼酸咖啡因治疗早产低出生体重儿呼吸暂停综合征的临床疗效[J].宁夏医科大学学报,2015,37 (12) :1447-1450.
[8] Schoen K,Yu T,Stockmann C,et al. Use of methylxanthine therapies for the treatment and prevention of apnea of prematurity[J]. Paediatr Drugs,2014,16(2):169-177.
[9] 杜立中.早产儿呼吸暂停的药物治疗[J].中国实用儿科杂志,2015,30(2):88-91.
[10] Ulanovsky I,Haleluya NS,Blazer S,et al.The effects of caffeine on heart rate variability in newborns with apnea of promaturity[J].J Perinatol,2014,34(8):620-623.
[11] 韩文,谢勇,任淑颖,等.潮气呼吸肺功能检测在1~4岁儿童喘息性疾病中的临床应用[J].中国当代儿科杂志,2014,16(8):800-804.
[12] Schmidt B,Roberts RS,Davis P,et al. Long-term effects of caffeine therapy for apnea of prematurity[J]. N Engl J Med,2007,357(19):1893-1902.
[13] Lodha A,Seshia M,McMillan DD,et al. Association of early caffeine administration and neonatal outcomes in very preterm neonates[J]. JAMA Pediatr,2015,169(1):33-38.
[14] 朱洪斌,高彩云,闫爱霞,等. 枸橼酸咖啡因联合正压通气治疗呼吸暂停早产儿的疗效及对血清饥饿激素、胰岛素样生长因子结合蛋白3的影响[J].中国妇幼保健,2018,33(3):595-598.
[15] Mosayebi Z,Javidpour M,Rahmati M,et al. The effect of Kangaroo mother care on pain from heel lance in preterm newborns admitted to neonatal intensive care unit:a crossover randomized clinical trial [J].Iranian Society Pediatri Corp,2015,5(4):e22214.
[16] 梁辉标,陈丽,蓝晓林.IGF-1、IGFBP-3 与新生儿出生体重及巨大儿出生率的关系研究[J].中国优生与遗传杂志,2015,21(11):85-87.
[17] Doyle LW,Schmidt B,Anderson PJ,et al. Reduction in developmental coordination disorder with neonatal caffeine therapy [J].J Pediatr,2014,165(2):356-359.
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