目的 探讨枸橼酸咖啡因与氨茶碱治疗早产儿原发性呼吸暂停的疗效与安全性.方法 回顾性分析2013 年3 月至2014 年3 月收治的125 例诊断有原发性呼吸暂停的早产儿的临床资料,根据治疗措施不同分为枸橼酸咖啡因组(n=65)和氨茶碱组(n=60).比较两组治疗的有效率及不良反应发生率.结果 枸橼酸咖啡因组有效56 例(86%),氨茶碱组有效43 例(72%),两组比较差异有统计学意义(P<0.05);枸橼酸咖啡因组发生心动过速1 例、烦躁不安5 例、喂养不耐受7 例、电解质紊乱2 例、高血糖5 例,各种不良反应的发生率均低于氨茶碱组(P<0.05).结论 枸橼酸咖啡因治疗早产儿原发性呼吸暂停疗效优于氨茶碱,不良反应发生率较低.
Abstract
Objective To investigate the clinical efficacy and safety of caffeine citrate and aminophylline in the treatment of primary apnea in premature infants. Methods The clinical data of 125 premature infants with primaryapnea from March 2013 to March 2014 were retrospectively analyzed. According to the therapeutic strategy, the patientswere divided into caffeine citrate group (n=65) and aminophylline group (n=60). The overall response rates and adversereaction rates in the two groups were compared. Results The overall response rate in the caffeine citrate group was 86% (56 cases), which was significantly higher than that in the aminophylline group (72%, 43 cases) (P<0.05). The adverse reactions in the caffeine citrate group included tachycardia (1 case), restlessness (5 cases), feeding intolerance(7 cases), electrolyte disturbance (2 cases), and high blood glucose (5 cases), the incidence of which was significantly lower than that in the aminophylline group (P<0.05). Conclusions Caffeine citrate is more effective and causes feweradverse reactions than aminophylline in the treatment of primary apnea in premature infants.
关键词
枸橼酸咖啡因 /
氨茶碱 /
原发性呼吸暂停 /
早产儿
Key words
Caffeine citrate /
Aminophylline /
Primary apnea /
Premature infant
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参考文献
[1] Moriette G, Lescure S, EI Ayoubi M, et al. Apnea of prematurity:what's new[J]. Arch Pediatr, 2010, 17(2):186-190.
[2] Janvier A, Khairy M, Kokkotis A, et al. Apnea is associated with neurodevelopmental impairment in very low birth weight infants[J]. J Perinatol, 2004, 24(12):763-768.
[3] 邵肖梅, 叶鸿瑁, 丘小汕. 实用新生儿学[M]. 第4 版. 北京:人民卫生出版社, 2011:245-247.
[4] 张国庆, 邵肖梅, 陆春梅. NICU 出院早产儿1 岁时神经发育 预后及干预依从性对其的影响[J]. 中国当代儿科杂志, 2007, 9(3):193-197.
[5] Davis PG, Schmidt B, Roberts RS, et al. Caffeine for apnea of prematurity trial:benefits may vary in subgroups[J]. J Pediatr, 2010, 156(3):382-387.
[6] Mueni E, Opiyo N, English M. Caffeine for the management of apnea in preterm infants[J]. Int Health, 2009, 1(2):190-195.
[7] Fredholm BB, Battig K, Holman J, et al. Actions of caffeine in the brain with special reference to factors that contribute to its widespread use[J]. Pharmacol Rev, 1999, 51(1):83-133.
[8] Gannon BA. Theophylline or caffeine:which is best for apnea of prematurity[J]. Neonatal Netw, 2000, 19(8):33-36.
[9] Clark RH, Bloom BT, Spitzer AR, et a1. Reported medication use in the neonatal intensive care unit:data from a large national data set[J]. Pediatrics, 2006, 117(6):1979-1987.
[10] Henderson-Smart DJ, Davis PG. Prophylactic methylxanthines for extubation in preterm infants[J]. Cochrane Database Syst Rev, 2003, (1):CD000139.
[11] Schmidt B, Roberts RS, Davis P, et al. Caffeine therapy for apnea of prematurity[J]. N Engl J Med, 2006, 354(20):2112-2121.
[12] Gray PH, Flenady VJ, Charles BG, et al. Caffeine citrate for very preterm infants:effects on development, temperament and behaviour[J]. J Paediatr Child Health, 2011, 47(4):167-172.