枸橼酸咖啡因与氨茶碱治疗早产儿呼吸暂停的疗效比较

Efficacy of Citrated Caffeine versus Aminophylline for Apnea of Prematurity

目的：观察枸橼酸咖啡因治疗早产儿呼吸暂停的疗效。方法：选择妊娠26～32周出生、出生后24 h或更长一段时间呼吸暂停发作1次或1次以上的早产儿66例，按床位先后顺序分为2组，枸橼酸咖啡因组（观察组）33例，采用负荷量20 mg／kg（相当于咖啡因碱基10 mg／kg）静脉滴注（30 min），间隔24 h后给予5 mg／（ kg· d）[相当于咖啡因碱基2.5 mg／（ kg· d）]静脉滴注或口服；氨茶碱组（对照组）33例，采用首剂5.0 mg／kg静脉滴注，间隔8～12 h后给予1次2.0 mg／kg、2次／d，治疗5 d。结果：观察组治疗方案在降低呼吸暂停发病率方面与对照组的差异无统计学意义（P＞0.05）。结论：静脉注射枸橼酸咖啡因20 mg／kg（相当于咖啡因碱基10 mg／kg），后续5 d静脉注射或口服枸橼酸咖啡因5 mg／（ kg· d）[相当于咖啡因碱基2.5 mg／（ kg· d）]，对治疗妊娠26～32周的早产儿呼吸暂停的疗效与氨茶碱相当。

OBJECTIVE：To evaluate the efficacy of caffeine citrate for apnea of prematurity.METHODS：A total of 66 premature infants at gestational age of 26 to 32 weeks with apnea attack of at least one time within 24 hrs or longer after birth were enrolled, with 33 assigned to observation group treated with citrated caffeine at load dosage of 20 mg/kg （ caffeine base 10 mg/kg） by intravenous infusion （30 min） , 24 hrs later, then the patients were administered intravenously or orally with citrated caffeine at dosage of 5 mg/（kg· d）[caffeine base 2.5 mg/（kg· d）], another 33 were assigned to control group treated intravenously with aminophylline at initial dose of 5.0 mg/kg, 8-12 hours later, these patients were treated with aminophylline at dosage of 2.0 mg/kg bid for 5 days.RESULTS： There was more reduction in the incidence of apnea in the observation group than in the control group, but the differences between the two groups were not statistically significant （P〉0.05）.CONCLUSIONS： Caffeine citrate administered intravenously at a dose of 20 mg/kg （ equivalent to caffeine base 10 mg/kg） followed by intravenous or oral administration at dosage of 5 mg/（ kg· d） [ equivalent to caffeine base base 2.5 mg/（ kg· d） ] for 5 days is as effective as theophylline for apnea of prematurity in the premature infants born after gestation of 26 to 32 weeks.