Aminophylline Versus Caffeine Citrate For Apnea Of Prematurity

Background.Apnea is a great threat to the life and prognosis of premature. Methylxanthine is recognized as the most effective medication. Caffeine citrate as the most remarkable medicine of methylxanthine has been used for decades world-widely. However, it was introduced to China as a kind of medicine to treat AOP only in past few years, and Chinese pediatrician usually had to use aminophylline previously.Objective.The objective of study was to compare caffeine citrate with aminophylline caffeine citrate in therapy for AOP.It included the effectiveness, security, cost performance, short-term complications of caffeine citrate and aminophylline.Object.The object include all premature in NICU of PUMCH from Jan 2013 to Jan 2015, whose gestational age were less than 34 weeks and birth weight less than 1800g. They were required to receive methyixanthine in first 10 days. We eliminated the patients died before PMA 36 weeks. The infants had sever deformities were rejected too.Methods.Finish the investigation designed beforehand. Make analyses and statistic of the data, Then compare the deffirence in effectiveness, security, cost performance and short-term complications between two groups, and 30 casee were assignResults.1. Effectiveness:there was no significant difference between caffeine citrate group and aminophylline group.2.Security:comparing the caffeine citrate group and aminophylline group,there was nobody reduced the dose for the adverse reactions in the former group, but there were 5 patients(17%) of latter group reduced the dose. P=0.021.The former group had 29 cases (97%) that suffered tachycardia, the latter group had 21 cases (70%), P=0.006. There were no significant difference of the utilization ratio of feeding intolerance and hyperglycemia between of two groups. The median day that suffered feeding intolerance of caffeine citrate group to caffeine citrate group is 8.5 days to 2 days, P=0.009. The duration of hyperglycemia is 2 days to 1 day, P=0.010.3.cost performance:there was no statistically significant between caffeine citrate group and aminophylline group.4. short-term complications:there was no significant difference between caffeine citrate group and aminophylline group.Discuss.In the end, there were 60 cases eligible. According to the methylxanthine they recived,30 cases were assigned to caffeine citrate group and 30 cases were assigned to aminophylline group. There were not significant differences in effectiveness, security, cost performance and short-term complications between caffeine citrate group and aminophylline group. But the study found the side effects of caffeine were fewer than the side effects of aminophylline, and the occurrence time of feeding tolerance was delayed. Caffeine may be better than aminophylline in security, we should make RCT and evaluation in two kinds of medicine in the future.