关键词: 早产儿, 枸橼酸咖啡因, 呼吸暂停

Abstract: Objective To study the effect of different doses of caffeine citrate on the treatment of premature infants with primary apnea,so as to provide evidence for the appropriate use of caffeine citrate in clinical practice.Methods A total of 133 cases of premature infants diagnosed with primary apnea in the neonatal intensive care unit of the Second Hospital of Shandong University were selected from January 2015 to June 2016. Caffeine citrate was used to treat apnea,and the children were randomly divided into high-dose group (n=85) and low-dose group (n=50) according to the maintenance dose. In both groups,20 mg/(kg·d) caffeine citrate was used as the loading dose,which was maintained for 24 hours. After that,8—10 mg/(kg·d) caffeine citrate was given in the high-dose group and 5—7.9 mg /(kg·d) in the low-dose group. After 5 days of treatment,the effective rate of treatment,changes in attack frequency,changes in severity and ventilator utilization rate were compared between the two groups. Results The effective rate of treatment in high-dose group(86.0%) was significantly higher than that of low-dose group(72.0%),the average number of apnea episodes and severity of apnea were significantly lower in high-dose group(P＜0.05),while the difference on ventilator utilization rate between the two groups was not significant(P＞0.05). Also,children were divided into two groups according to their gestational age at birth,including <32 weeks and ≥32 weeks. The average number of apnea episodes and severity of apnea in high-dose group were significantly lower than those in low-dose group in the same gestational age group (P＜0.05). While there were no significant differences on apnea episodes and severity of apnea between different gestational age groups at the same dose(P＞0.05). Besides,the incidence of adverse reactions between the two groups was not significantly different either (P＞0.05). Conclusion Caffeine citrate is more effective in treating premature infants with apnea at maintenance of 8—10 mg/(kg·d ) than maintenance of 5—7.9 mg/(kg·d ),which does not increase the incidence of adverse reactions.

Key words: caffeine citrate, apnea, premature infants