坚持才会提高 | 医学英语精听:咖啡因能有效治疗早产儿的呼吸问题

小白老师2015/12/07英语学习

摘要: 咖啡因作为一种甲基黄嘌呤类生物碱,已被临床证实可有效减少早产儿呼吸暂停的发生,并改善其长期神经发育结局,且具有良好的安全性。

  • 咖啡因是治疗早产儿呼吸暂停的常用药物,因其在婴儿体内半衰期较长而被优先选用。
  • 大型多国随机对照研究显示,接受咖啡因治疗的早产儿在18至21月龄时脑瘫和认知滞后发生率显著降低。
  • 长期随访至5岁发现,无论是否接受咖啡因治疗,极早产儿均表现出显著的神经发育“追赶”潜力。
  • 研究确认咖啡因治疗不仅有效,而且在长期使用中未观察到明显副作用。
  • 尽管早期缺乏充分证据,但数十年临床实践与后续研究共同验证了咖啡因的安全性和疗效。

小白老师说:请先阅读News Background,然后点击下方条形框播放音频。

News Background

早在30多年前,临床医生们就发现甲基黄嘌呤类生物碱能够降低早产儿呼吸暂停的发生率。从那时起,甲基黄嘌呤类生物碱就成了早产儿呼吸暂停常规临床治疗的一个部分。由于该类药物中的咖啡因在婴儿体内的半衰期较长,所以在临床治疗中最常用到。

《新英格兰医学》杂志已发表过一项研究,施密特等人报告了这项临床研究的长期随访结果,发现随机分配接受咖啡因治疗的婴儿月龄为18 ~21个月时,存活率得到改善,而且不伴有神经系统发育异常,这也是该研究的主要观察结果。而且,咖啡因组与安慰剂治疗组的婴儿相比,小儿脑瘫和认知滞后的发生率降低,死亡、耳聋以及失明的发生率在两组之间没有显著差异。

News Transcri****pt

Almost all babies who are born veryprematurely have trouble breathing. For decades, doctors have treated themwith the stimulant (兴奋剂) caffeine, even though there was little scientific evidence to **justify(**证明合法) it. Now research confirms caffeine is a sage and effective treatment.

In an earlier stage of this study, some2,000 premature babies in nine countries were randomly assigned to get caffeineor a placebo. At 18 months, researchers found numerous advantages for thecaffeine group. Those babies had half as many cases of **cerebral palsy(**脑瘫) as well as lower rates ofblindness, deafness and delayed mental functioning (****心理功能).

Now, researcher Barbara Schmidt of the University of Pennsylvania and college report on anadditional three and a half years of follow-up, mainly to look for possiblesafety issues, which might take time to develop.

She says the new study confirms theeffectiveness of the caffeine treatment, and underscores its lack of sideeffects.

“Not only is it safe, it is more effectivethan any other drugs we give to babies in the **nursery (**育儿箱) when they are very preterm(****早产的).”

Schmidt’s research paper, that rates of **cognitive (**认知的) **impairment (**损伤,损害) atfive years were much lower than at 18 months—what she calls a potential for “remarkablecatch-up” in the very premature babies as they get older, whether they getcaffeine therapy or not. Barbara Schmidt research is published in the Journalof American Medical Association JAMA.

小白老师说:

Fordecades, doctors have treated them with the stimulant(兴奋剂) caffeine, even though there waslittle scientific evidence to justify(证明合法) it.

此句中,播音员将单词caffeine进行了重读,表明这是本句的重要信息,与咖啡因有关。另外,even though“尽管”,表示转折,even though引导让步状语从句是以从句的内容为先决条件的,即说话人肯定了从句的事实,表示已经发生了的事,在听力过程中要注意把握这一信息。

常见问题

为什么咖啡因被用于治疗早产儿呼吸问题?

因为咖啡因属于甲基黄嘌呤类生物碱,能刺激中枢神经系统,减少早产儿呼吸暂停的发生,且在婴儿体内作用时间较长。

咖啡因治疗对早产儿的长期发育有何影响?

研究显示,接受咖啡因治疗的早产儿在18~21个月时脑瘫和认知滞后风险更低,且随访至5岁时未发现明显不良反应。

这项研究的主要结论是什么?

咖啡因治疗不仅安全有效,还能显著改善极早产儿的神经发育结局,是新生儿重症监护中优于其他药物的干预手段。

参考资料

Schmidt B, et al. Long-Term Effects of Caffeine Therapy for Apnea of Prematurity. New England Journal of Medicine.

该研究首次报告了咖啡因治疗对早产儿18~21月龄神经发育结局的积极影响。

Schmidt B, et al. Five-Year Follow-up of Caffeine Therapy for Apnea of Prematurity. JAMA.

后续研究进一步证实咖啡因治疗的长期安全性及早产儿神经发育的‘追赶’现象。