Comparison On The Efficacy And Safety Of Different Doses Caffeine Citrate And Aminophylline In Treatment Of Premature Infants With AOP

BackgroundPremature infants are prone to AOP due to immature development of respiratory center and incomplete anatomical structure of respiratory system.If they are not timely and effective treatmented,which may lead to a series of sequelae and the life of infants may even be endangered.At present,caffeine citrate and aminophylline are the main drugs.However,it is not clear that the different doses caffeine citrate and aminophylline in efficacy,safety,cost-effectiveness and short-term complications to AOP.ObjectiveThe objective of this study was to compare the clinical effect of different doses caffeine and aminophylline in the treatment of premature infants with AOP,and investigate the efficacy and safety of caffeine citrate.MethodsAccording to inclusion and exclusion criteria,the object includes 107 premature infants with primary apnea cases in our hospital from January 2017 to December 2017.Depending on the type and dose of the drug: A,B and C.Group A: 42 cases,male 25 and female 17,average gestational age(32.13 ± 1.66)weeks;Group B: 35 cases,male 20,female 15,average gestational age(31.32±1.72)weeks;Group C: 30 cases,male 16,female 14,average gestational age(32.82±1.66)weeks.Group A was treated with a maintenance dose of 5 mg/kg of caffeine citrate.Group B was treated with a maintenancedose of 10 mg/kg of caffeine citrate.Group C was treated with a dose of 4 mg/kg of aminophylline.The therapeutic effect,drug safety and the incidence of short-term complications of apnea in three groups were compared and analyzed.Results1.Basic data: there were no significant differences among the three groups in terms of gestational age,birth weight,gender and delivery mode(cesarean section/natural delivery)(P > 0.05).2.Effectiveness: the effective rate of the high-dose caffeine citrate group(82.9%)was higher than that of the conventional dose group(57.1%)with statistically significant(P<0.05).However,there was no significant difference in the effective rate between the two groups caffeine citrate and the aminophylline group(P > 0.05).Compared with the conventional dose group and aminophylline group,the high-dose group had better effects in improving the children's blood gas index,reducing the number of apnea,and improving the success rate of machine withdrawal(P<0.05).Non-invasive auxiliary ventilation time,oxygen use time and hospitalization time in the high-dose/routine dose group were significantly shorter than that in the aminophylline group(P<0.05).Especially in the high-dose group compared with the aminophylline group,the difference was more significant.3.Security: the incidence of tachycardia and hyperglycemia in the high-dose/conventional dose group of caffeine citrate were lower than that in the aminophylline group(P<0.05),and there was no significant difference between the high-dose group and the conventional dose group(P>0.05).The incidence of adverse reactions of "feeding intolerance" and "drop of blood pressure " in the three groups were compared,and there were no significant difference(P>0.05).4.Short-term complications: The incidence of short-term complications such as bronchopulmonary dysplasia,retinopathy of premature infants,necrotizing enterocolitis and intracranial hemorrhage in the three groups were compared and analyzed,and there were no significant difference(P>0.05).ConclusionCompared with aminophylline,caffeine citrate is of higher security.Additional the clinical curative effect of high dose caffeine citrate is better.