枸橼酸咖啡因联合肺表面活性物质治疗新生儿呼吸窘迫综合征对血清炎症因子及血气指标的影响

Effects of caffeine citrate with pulmonary surfactant on serum inflammatory factors and arterial blood gas in the treatment of neonatal respiratory distress syndrome

摘要:

目的 研究枸橼酸咖啡因与肺表面活性物质联合治疗新生儿呼吸窘迫综合征（NRDS）对患儿炎症因子及血气分析指标的影响。方法 选取2019年1月—2023年12月阜阳市人民医院80例NRDS患儿为研究对象，并随机平均分为两组。实验组予以注射用牛肺表面活性物质联合枸橼酸咖啡因注射液治疗，对照组仅予以注射用牛肺表面活性物质。对比两组患儿血清炎症因子和血气指标，并采用Spearman法进行相关性分析。结果 实验组治疗前后肿瘤坏死因子-α（TNF-α）、白细胞介素-6（IL-6）和血清淀粉样蛋白A的差值均高于对照组（P <0.05）。实验组治疗前后动脉血氧分压、动脉血二氧化碳分压及氧合指数（OI）的差值均高于对照组（P <0.05）。实验组患儿血清TNF-α（r_s =0.946，P =0.000）、IL-6（r_s =0.672，P =0.000）与OI均呈正相关。结论 枸橼酸咖啡因联合肺表面活性物质治疗NRDS可以降低患儿血清炎症因子水平，改善患儿血气指标，实验组患儿随着血清TNF-α、IL-6水平下降，OI也降低。

Abstract:

Objective To study the effects of caffeine citrate combined with pulmonary surfactant on cytokine levels and arterial blood gas results in the treatment of neonatal respiratory distress syndrome (NRDS).Methods From January 2019 to December 2023, 80 NRDS hospitalized neonates were incorporated into the study and randomly divided into two groups, with 40 cases in each group. The experimental group received combination therapy (bovine pulmonary surfactant for injection and caffeine citrate injection), while the control group received pulmonary surfactant for injection only. The serum cytokine levels and arterial blood gas results were compared, and correlation analysis was carried out.Results The experimental group demonstrated significantly greater reductions in serum TNF-α, IL-6, and SAA levels from baseline compared to the control group (P < 0.05). Notably, more pronounced improvements in pulmonary oxygenation parameters were documented in the experimental group, as evidenced by larger increases in PaO? and OI, coupled with greater decreases in PaCO? levels, all reaching statistical significance compared to the control group (P < 0.05). Robust positive associations were identified between inflammatory markers and oxygenation status within the experimental cohort, with Spearman correlation coefficients revealing strong relationships between OI values and TNF-α (r_s = 0.946, P = 0.000) as well as IL-6 concentrations (r_s = 0.672, P = 0.000).Conclusion The combination therapy of NRDS with caffeine citrate and pulmonary surfactant can reduce serum cytokine levels and improve arterial blood gas indexes. In the experimental group, the OI decreased with the decrease of serum TNF-α and IL-6 levels.