不同剂量咖啡因治疗早产儿呼吸暂停疗效及安全性分析

Efficacy and safety analysis of different doses of caffeine in the treatment of premature infants with apnea

目的探讨不同剂量枸橼酸咖啡因在早产儿呼吸暂停中的临床疗效及安全性。方法选择2019年6月至2020年12月早产儿呼吸暂停患儿93例为研究对象,给予咖啡因治疗干预,根据用药剂量不同分为低剂量组、中剂量组与高剂量组。低剂量组首次用药20 mg/kg,24 h后每日维持量为5 mg/kg、中剂量组首次用药剂量为20 mg/kg,24 h后每日维持量为10 mg/kg及高剂量组首次用药剂量20 mg/kg,24h后每日维持量为15 mg/kg,比较三组治疗效果、不良反应及患儿临床结局。结果高剂量组呼吸暂停次数低于低剂量组和中剂量组(P<0.05);中剂量组呼吸暂停次数低于低剂量组(P<0.05)。三组药物总不良反应发生率比较,差异无统计学意义(P>0.05)。三组患儿死亡、支气管肺发育不良或产生其他并发症发生率比较,差异无统计学意义(P>0.05)。结论高剂量枸橼酸咖啡因用于早产儿呼吸暂停中效果良好,能获得良好的临床结局,且未增加不良反应发生率。

Objective To investigate the clinical efficacy and safety of different doses of caffeine citrate in premature infants with apnea.Methods A total of 93 premature infants with apnea admitted to our hospital from June 2019 to Decemner 2020 were selected as research objects.All infants were given caffeine,and they were divided into the low dose group,the middle dose group and the high dose group according to different doses of administration.The low dose group was treated with 20 mg/kg caffeine for the first time,and 24 h later,they were given 5 mg/kg caffeine as a daily dose.The middle dose group was treated with 20 mg/kg caffeine at the first administration,and the daily maintenance dose was 10 mg/kg 24 h later.The high dose group was treated with 20 mg/kg for the first time,and the daily maintenance dose was 15 mg/kg 24 h later.The therapeutic effects,adverse reactions and clinical outcomes of the three groups were compared.Results The frequency of apnea was lower in the high dose group than that in the low dose group and the middle dose group(P<0.05).The frequency of apnea was lower in the middle dose group than that in the low dose group(P<0.05).There was no significant difference in the incidence of total adverse reactions among the three groups(P>0.05).There were no significant differences in the mortality,the incidence of bronchopulmonary dysplasia or other complications among the three groups(P>0.05).Conclusion High dose caffeine citrate is effective in premature infants with apnea,which can obtain good clinical outcomes without increasing the incidence of adverse reactions.