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

摘要
图/表
参考文献(20)
相关文章 (8)

全文: PDF (0 KB) HTML (36 KB)
输出: BibTeX | EndNote (RIS)

摘要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。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章
	杨美君

关键词 ：原发性呼吸暂停, 极早产儿, 枸橼酸咖啡因, 振幅整合脑电图

Abstract：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.

Key words： Apnea of prematurity Very pretern infant Caffeine citrate Amplitude integrated electroencephalography

作者简介: 杨美君（1985-），女，硕士，研究方向：新生儿科学。

引用本文:

杨美君. 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[J]. 中国当代医药, 2021, 28(29): 132-135.
YANG Mei-Jun. 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. 中国当代医药, 2021, 28(29): 132-135.

链接本文:

http://dangdaiyiyao.com/CN/ 或 http://dangdaiyiyao.com/CN/Y2021/V28/I29/132

[1]	陈静，陈晓，龚放.不同维持剂量枸橼酸咖啡因治疗早产儿呼吸暂停疗效和安全性的meta 分析[J].临床儿科杂志，2018，36（9）：55-59.
[2]	王家玉，肖磊，胡亚澜，等.高剂量与常规剂量咖啡因治疗早产儿呼吸暂停症的系统评价[J].药物流行病学杂志，2019，28（11）：728-732.
[3]	Padden B，Scheer I，Brotschi B，et al.Does amplitude-integrated electroencephalogram background pattern correlate with cerebral injury in neonates with hypoxic-ischaemic encephalopathy?[J].J Paediatr Child Health，2015，51（2）：180-185.
[4]	邵肖梅，叶鸿瑁，丘小汕．实用新生儿学[M].5 版.北京：人民卫生出版社，2018：610-612.
[5]	施亿赟，程国强，邵肖梅，等.正常早产儿振幅整合脑电图特点的研究[J].中华儿科杂志，2011，49（9）：648-654.
[6]	Anyanwu AC，Bentley JK，Popova AP，et al.Suppression of inflammatory cell trafficking and alveolar simplification by the heme oxygenase-1 product carbon monoxide[J].Am J Physiol Lung Cell Mol Physiol，2014，306（8）：L749-L763.
[7]	杨洋，程锐，吴琦，等.不同起始时间应用咖啡因对早产儿安全性及有效性的评估：一项江苏省多中心研究[J].中国当代儿科杂志，2020，22（2）：49-54.
[8]	林建丰，庄泽吟，陈淑特.枸橼酸咖啡因在早产儿呼吸机辅助通气中的临床效果[J].中国当代医药，2019，26（35）：159-162.
[9]	秦素芳.枸橼酸咖啡因在早产儿原发性呼吸暂停中的研究进展[J].中国当代医药，2018，25（36）：25-27.
[10]	Alhersh E，Abushanab D，Al-Shaibi S，et al.Caffeine for the Treatment of Apnea in the Neonatal Intensive Care Unit：A Systematic Overview of Meta-Analyses[J].Pediatr Drugs，2020，22（4）：399-408.
[11]	杨瑞芬.枸橼酸咖啡因治疗早产儿呼吸暂停的效果[J].实用临床医学，2020，21（8）：54-55.
[12]	孟伟玲，刘庆生，刘玉荣，等.枸橼酸咖啡因改善早产儿辅助通气及呼吸暂停的临床效果及安全性分析[J].临床肺科杂志，2020，25（2）：281-283，287.
[13]	Sanchez-Solis M，Garcia-Marcos PW，Agüera-Arenas J，et al.Impact of early caffeine therapy in preterm newborns on infant lung function[J].Pediatr Pulmonol，2020，55（1）：102-107.
[14]	Ulanovsky I，Haleluya NS，Blazer S，et al.The effects of caffeine on heart rate variability in newborns with apnea of prematurity[J].J Perinatol，2014，34（8）：620-623.
[15]	Frymoyer A，Su F，Grimm PC，et al.Theophylline Population Pharmacokinetics and Dosing in Children Following Congenital Heart Surgery With Cardiopulmonary Bypass[J].J Clin Pharmacol，2016，56（9）：1084-1093.
[16]	Muhammad M，El-Ta′alu AB，Mohammed MA，et al.Effect of caffeine on serum tumour necrosis factor alpha and lactate dehydrogenase in Wistar rats exposed to cerebral ischaemia-reperfusion injury[J].Niger J Physiol Sci，2018，33（1）：3-8.
[17]	Lodha A，Entz R，Synnes A，et al.Early Caffeine Administration and Neurodevelopmental Outcomes in Preterm Infants[J].Pediatrics，2019，143（1）：889-899.
[18]	Ravichandran S，Chouthai NS，Patel B，et al.Higher daily doses of caffeine lowered the incidence of moderate to severe neurodevelopmental disabilities in very low birth weight infants[J].Acta Paediatr，2019，108（3）：430-435.
[19]	Czaba-Hnizdo C，Olischar M，Rona Z，et al.Amplitude-integrated electroencephalography shows that doxapram influences the brain activity of preterm infants[J].Acta Paediatr，2015，103（9）：922-927.
[20]	Burdjalov VF，Baumgart S，Spitzer AR.Cerebral function monitoring：a new scoring system for the evaluation of brain maturation in neonates[J].Pediatrics，2003，112（4）：855-861.