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及安全性比较

Comparison of efficacy and safety of citrate caffeine and aminophylline in the treatment of primary apnea in premature infants

目的比较枸橼酸咖啡因与氨茶碱治疗早产儿原发性呼吸暂停的临床效果及安全性。方法选择2016年5月至2017年5月我院收治的原发性呼吸暂停早产儿为研究对象,随机分为两组,分别采用枸橼酸咖啡因注射液治疗(咖啡因组)以及氨茶碱注射液治疗(氨茶碱组)。比较两组患儿的呼吸暂停次数、有创机械通气及无创机械通气时间、吸氧时间以及心动过速血压下降、喂养不耐受、高血糖的发生率。结果治疗7 d后,咖啡因组患儿72 h内平均呼吸暂停次数、无创机械通气时间、有创机械通气时间、吸氧时间显著少于或短于氨茶碱组,差异有统计学意义(P <0. 05)。咖啡因组患儿心动过速的发生率(19. 2%)显著低于氨茶碱组(30. 3%),差异有统计学意义(P <0. 05);两组患儿血压下降、喂养不耐受、高血糖的发生率比较,差异无统计学意义(P> 0. 05)。结论枸橼酸咖啡因治疗早产儿呼吸暂停的疗效以及治疗安全性均高于氨茶碱治疗。

Objective To compare the clinical efficacy and safety of citrate caffeine and aminophylline in the treatment of primary apnea in premature infants.Methods The primary apnea premature infants admitted to our hospital from May 2016 to May 2017 were randomly divided into two groups,who were treated with citrate caffeine injection and aminophylline injection respectively.The number of apneas,invasive mechanical ventilation and non-invasive mechanical ventilation,and duration of oxygen inhalation were compared between the two groups.The incidence of tachycardia,decreased blood pressure,feeding intolerance,and hyperglycemia were compared between the two groups too.Results After 7 days of treatment,the average number of apneas,non-invasive mechanical ventilation duration,invasive mechanical ventilation duration,and oxygen inhalation duration in 72 h were significantly less in the caffeine group than in the aminophylline group,which was statistically significant(P<0.05).The incidence of tachycardia in the caffeine group(19.2%)was significantly lower than that in the aminophylline group(30.3%),and the difference was statistically significant(P<0.05).There was no significant difference in the incidence of blood pressure,feeding intolerance,and hyperglycemia between the two groups(P>0.05).Conclusion The efficacy and safety of caffeine in the treatment of apnea in preterm infants are higher than those in aminophylline.