关键词: 咖啡因, 早产儿视网膜病, 胰岛素样生长因子1, 血管内皮生长因子, 枸橼酸咖啡因

Abstract: Objective　To investigate the effect of caffeine citrate on the prevention of retinopathy in prematurity (ROP). Methods　A total of 148 premature infants (gestational age from 24 to 32 weeks) admitted to Foshan Maternity and Child Healthcare Hospital Affiliated to Southern Medical University were included and randomly divided into study group (71 cases) and control group (77 cases). Both groups were given regular treatment of premature infants. At the same time，the study group was given caffeine citrate 20 mg/kg intravenous drip (time > 30 min). After 24-h interval, 5 mg/(kg·d) was given intravenously as maintenance dose. If apnea still occurred during the course of treatment, 10 mg/(kg·d) maintenance dose was given, and physical stimulation, oxygen therapy and respiratory support were given to promote the recovery of spontaneous breathing until the gestational age was corrected to 37 weeks or they discharged from hospital. The serum levels of insulin-like growth factor-1 (IGF-1) and vascular endothelial growth factor (VEGF) were detected by enzyme-linked immunosorbent assay (ELISA) at the first week after birth and 36 weeks of corrected gestational age. Fundus screening was started at 4 weeks after birth or 32 weeks of corrected gestational age, and the incidence of ROP was counted. Results　At the first week after birth, the levels of IGF-1 and VEGF were significantly higher in the study group than those in the control group (P＜0.05). At 36 weeks of corrected gestational age, the serum levels of IGF-1 and VEGF were significantly increased in the control group, while the serum levels of IGF-1 and VEGF had no significant changes in the study group. The serum levels of IGF-1 and VEGF were lower in the study group than those in the control group (P＜0.05). Compared with the control group, the total incidence rate of ROP [11.3% (8/71) vs. 46.8% (36/77)] and the incidence rate of severe ROP [Ⅲ-Ⅴ period, 1.4% (1/71) vs. 13.0% (10/77)] were significantly lower in the study group (P＜0.05). Conclusion　Caffeine citrate has a positive effect on the prevention of ROP and can reduce the incidence rate of severe ROP.

Key words: caffeine, retinopathy of prematurity, insulin-like growth factor 1, vascular endothelial growth factors, caffeine citrate