两种药物治疗原发性呼吸暂停早产儿临床对比研究

Clinical comparative study of two kinds of drugs in the treatment of preterm infants with primary apnea

目的探讨氨茶碱与枸橼酸咖啡因治疗原发性呼吸暂停早产儿临床疗效及安全性差异。方法研究对象选取原发性呼吸暂停早产儿共130例，随机分为氨茶碱组（65例）和枸橼酸咖啡因组（65例），分别在对症干预基础上加用氨茶碱与枸橼酸咖啡因组治疗；比较2组患儿总氧疗时间、机械通气时间、住院时间、随访并发症发生率及远期发育商水平等。结果枸橼酸咖啡因组患儿总氧疗时间、机械通气时间及住院时间较氨茶碱组显著缩短（P<0.05）；枸橼酸咖啡因组患儿PDA、BPD及ROP发生率较氨茶碱组显著降低（P<0.05）；2组患儿颅内出血、PVL及NEC发生率比较差异无显著性，枸橼酸咖啡因组患儿治疗后24w和48w发育商水平较氨茶碱组显著提高（P<0.05）。结论与氨茶碱相比，在对症干预基础上加用枸橼酸咖啡因用于原发性呼吸暂停早产儿能够显著减少氧疗和机械通气时间，缩短临床病程，避免相关并发症发生，且在促进远期智力发育方面优势明显。

Objective To investigate the clinical effects and safety of Aminophylline and Caffeine citrate in the treatment of preterminfants with primary apnea.Methods130preterm infants with primary apnea were chosen and randomly divided into both group including theAminophylline group(65children)with aminophylline and the Caffeine citrate group(65children)with Caffeine citrate on the basis of conventionalintervention;and the total oxygen inhalation time,mechanical ventilation time,hospitalization time,the complications incidence with follow-upand the levels of development quotient for short-term of both groups were compared.Results The total oxygen inhalation time,the mechanicalventilation time and the hospitalization time of Caffeine citrate group were significantly shorter than aminophylline group(P<0.05).The incidenceof PDA,BPD and ROP of Caffeine citrate group were significantly lower than aminophylline group(P<0.05).There was no significant differencein the incidence of intracranial hemorrhage,PVL and NEC between two groups.The development quotient levels in24weeks and48weeks aftertreatment of Caffeine citrate group were significantly higher than aminophylline group(P<0.05).Conclusion Compared with Aminophylline,Caffeine citrate on the basis of conventional intervention in the treatment of preterm infants with primary apnea could efficiently shorten the oxygeninhalation time,the mechanical ventilation time and clinical disease course,reduce the related complications risk and be helpful to promote theintellectual development.