摘要
早产儿和足月新生儿呼吸暂停是常见的早产新生儿严重疾病,持续的呼吸暂停会对脑部及器官发育造成危害。甲基黄嘌呤类化合物,如茶碱、咖啡因常用于治疗早产儿和足月新生儿呼吸暂停。其中,咖啡因治疗安全范围更大,给药1日1次,更受临床关注。咖啡因的安全性、有效性和性价比最好,可以减少最初2到7 d内的呼吸暂停发作次数以及间歇正压通气使用次数,降低经气管插管和经鼻导管持续气道正压通气的依赖时间、降低持续供氧的时间、提高撤机成功率、降低支气管肺发育不良发生率、减少动脉导管未闭、减少激素应用、视网膜病有积极治疗作用等。另外,咖啡因治疗可以减少正压通气时间,从而降低了总治疗成本。我国使用枸橼酸咖啡因用于早产儿和足月新生儿呼吸暂停的治疗。为此,笔者就咖啡因在早产儿和足月新生儿中的药动学及其在早产儿和足月新生儿呼吸暂停等相关疾病中的应用进展做一综述。
Apnea in premature infants is a common preterm neonatal serious disease, persistent apnea will cause harm to brain and organ development. Methylxanthine compounds such as theophylline and caffeine are used to treat apnea in premature infants. Among them, the caffeine treatment of greater safety and ease of administration once a day, and more attention due to caffeine safe, effective, cost-effective the best, Aranda described it as ＂ silver bullet in neonatal medicine＂. Caffeine reduced the number of apneic episodes during the first 2 to 7 d and the number of intermittent positive pressure ventilation use and showed a dependency on other beneficial effects such as can reduced time of tracheal intubation and nasal catheter continuous positive airway pressure, reduce the duration of continuous oxygen supply, improve the success rate of weaning, reduce the incidence of bronchopulmonary dysplasia, reduce patent ductus arteriosus, reduce the use of hormones, retinopathy of premature children have a positive therapeutic effect. Caffeine treatment reduces positive airway pressure, thereby reducing overall treatment costs. In 2013, China approved caffeine citrate for the treatment of apnea in premature infants. In this paper, the pharmacokinetics of caffeine in premature infants and its application in apnea and related diseases of premature infants were reviewed.
出处
《中国药学杂志》
CAS
CSCD
北大核心
2017年第21期1884-1888,共5页
Chinese Pharmaceutical Journal
基金
国家自然科学基金资助项目(81370776)
中国-世界卫生组织2016-2017双年度合作项目:儿童用药安全性和可及性相关因素对策研究资助项目(2016/647672-0)
关键词
早产儿呼吸暂停
药动学
支气管肺发育不良
咖啡因
神经发育
代谢
apnea in premature infants
pharmacokinetics
bronchopulmonary dysplasia
caffeine
neurodevelopment
metabolism
