| Apnea of prematurity(AOP)is a more common problem in premature infant respiratory management [1],and is closely related to gestational age and birth weight of preterm infants.The smaller the gestational age,the higher the incidence of apnea.The incidence of apnea in preterm infants with body weight <1000g was 80% [2].Gestational age 30 to 32 weeks premature apnea rate is about 50%.Apnea leads to hypoxemia,bradycardia,increased intraventricular hemorrhage,hydrocephalus and neurological dysplasia [3],and even life-threatening.At present,methyl xanthine drugs are the main drugs for the treatment of apnea.Aminophylline and caffeine citrate are both xanthine drugs.Studies have shown that caffeine citrate can reduce the mechanical ventilation time,the hypoxemia time and the incidence of bronchial pulmonary dysplasia.However,there are fewer researches on the lung development of infants.Premature infant lung function test is a very important means to identify the maturity of respiratory system [4],study the systemic diseases and reveal its growth and development [5].Lung function tests can identify the nature of the respiratory system disease,severity of the disease and monitor patients.It can also assist in the treatment of differing disease of the breathing machine,evaluation therapeutic effect,guiding and judging prognosis of disease.Normal lung function testing needs the active cooperation of the patients,which significantly limits itsapplication in newborns and children,while the tidal breathing lung function test only requires calm breathing with simple operation.Therefore,it is very suitable for newborns and becomes increasingly common in the clinical application of a wide range with more and more attention.This article explores the effect of caffeine citrate on the lung development of very low birth weight infants through the dynamic follow-up of the tidal breathing lung function of the very low birth weight infants with apnea during different periods after the treatment with caffeine citrate.Objective The article aims to discuss the effect of caffeine citrate on the lung function of very low birth weight infants through the tidal breathing lung function test on very low birth weight infants with apnea during hospitalization and the comparison of key respiratory parameters.Methods and Subjects 1.Subjects The research subjects are 120 very low birth weight infants(1000g ~ 1499g)with primary apnea from the neonatology division of the Third Affiliated Hospital of Zhengzhou University during the period from December 2015 to December 2016.The subjects are divided into the caffeine application group(observed group P1)and aminophylline group(control group P2)with 60 cases in each group according to the random number method.Exclusion criteria:(1)there is a history of severe perinatal asphyxia,nervous system diseases and disorders;(2)a history of asthma in first-degree relatives;(3)the mother has a history of smoking;(4)severe respiratory distress syndrome and other respiratory diseases and neuromuscular diseases;(5)intracranial hemorrhage;(6)sepsis and other infectious diseases;(7)the disease of digestive system and electrolyte disorder;(8)severe congenital heart disease;(9)genetic metabolic diseases;(10)patients that abandoning treatment,dead before assessment time,dissatisfied with drug treatment;(11)other causes of secondaryapnea [4].2.Methods This study chooses the tidal breathing,which fastens a mask to the nose and mouth of the infant in neonatal medicine sleep(drug with 10% chloral hydrate 0.3 ~ 0.5ml / kg enema or oral)or natural sleep with calm breath to convert the velocity signal into capacity through the velocity sensor with the measured value indicated by the computer.Routine records include neonatal gestational age,gender,the body length and weight before the test.Measurable parameters are tidal volume(TV),,inspiratory time(TI),expiratory time(TE),respiratory rate(RR),ratio of TPEF and total Te(TPEF/t E),ratio of VPEF and total VE(VPEF/VE).This study was approved by the human body Test Committee of our hospital and the written informed consent of the patient's family.The tidal breathing lung function testing on the subjects for the first time were after stopping caffeine citrate or aminophylline(no later than born after 34 weeks)and followed up the research subjects of both groups.The tidal breathing lung function testing was conducted on the both groups at the corrected gestational age of 40 weeks and 3 months after birth respectively.Statistical method was used to analyze and explore the effect of caffeine citrate on the tidal breathing lung function of very low birth weight infants in different periods.Results 1.Basic information comparison The two groups had no statistically significant difference in the age of birth,birth weight and 5min apgar score(p > 0.05).2.The difference in the main parameters of lung function between the groups determined after discontinuation(no later than 34 weeks after birth)The tidal volume of caffeine group was significantly higher than that ofaminophylline group(p <0.05),and the ratio of TPEF and total t E,the ratio of VPEF and total VE and the expiratory flow rate at 25% tidal volume of caffeine group were significantly higher than that of aminophylline group(p <0.05).Other indicators of pulmonary function had no statistically significant differences(p> 0.05).3.The difference of lung function parameters between the groups at the corrected gestational age of 40 weeks The tidal volume was significantly higher in the caffeine group at 40 weeks of corrected gestational age,and the ratio of TPEF and total t E,the expiratory flow rate at 50% and 25% tidal volume were higher than that of the aminophylline group with statistical difference(p<0.05).Other indicators of pulmonary function had no statistically significant differences(p> 0.05).4.Differences in lung function parameters between groups at 3 months after birth The tidal volume of caffeine in the premature postpartum group was higher than that in the aminophylline group with statistical difference(p<0.05).There was no significant statistical difference in the ratio of TPEF and total t E,the ratio of VPEF and total VE and the expiratory flow rate at 75%,50% and 25% tidal volume(p> 0.05).Conclusion The tidal breathing lung function in short and long term of very low birth weight infants with AOP using citrate caffeine treatment were significantly improved. |
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