| Objective:To evaluate the clinical efficacy and safety of caffeine by comparing the clinical datas of primary apnea in premature infants treated by caffeine citrate and aminophylline to evaluate the neurodevelopmental outcome at 1 year corrected age.Methods:The clinical data of preterm infants treated by caffeine citrate or aminophylline were collected from July 2015 to June 2017 in the neonatal department of the Children's Hospital affiliated to Soochow University,which were diagnosed with primary apnea.They were divided into caffeine citrate group(52 cases)and aminophylline group(69 cases),collected data including:Children's general information,illness,number of apnea,respiratory support,possible adverse reactions(arrhythmia,blood pressure changes,hyperglycemia,feeding intolerance)and complications during hospitalization(neonatal necrotizing enterocolitis,bronchial lung dysplasia,retinopathy of preterm infants,intracranial hemorrhage,etc.).The neurological behavior score of children at 1 year corrected age was performed by using the?Developmental Scale children aged 0-6 years?,and the neurodevelopmental outcomes of the two groups were compared.Results:1.Children with caffeine and aminophylline had no statistical difference in sex,gestational age,birth weight,1 minutes Apgar score,5 minutes Apgar score and time of drug use,and the baseline situation of the two groups were comparable,P>0.05.2.Within 3-7 days of caffeine citrate and aminophylline administration,the number of apnea episodes decreased in both groups.42 cases(80.77%)were effective in caffeine group and 50 cases(72.46%)were effective in aminophylline group.?2=1.122,P=0.289.There was no significant difference in the effective rates between the two groups.In the caffeine group,8 patients underwent non-invasive assisted ventilation,3 patients underwent invasive assisted ventilation with tracheal intubation,18 patients in the aminophylline group were upgraded with non-invasive assisted ventilation,and 5 patients were upgraded to invasive assisted ventilation.The differences between the two groups were not statistically significant,?2=2.344,P=0.310.3.There were tachycardia 4 cases(7.70%),hyperglycemia 6 cases(11.54%),blood pressure abnormalities 2 cases(3.85%),feeding intolerance 7 cases(13.46%)in caffeine group;and tachycardia 16 cases(23.19%),hyperglycemia 8 cases(11.59%),abnormal blood pressure in 4 cases(5.80%),feeding intolerance in 20 cases(28.98%)in aminophylline group.Statistics analysis showed that caffeine group had lower rates of tachycardia and feeding intolerance,the chi-square was 5.161 and 4.122,p values were 0.023 and 0.042.The remaining indexes were not significantly different.4.Among children with caffeine,7 cases(13.46%)suffered BPD,5 cases(9.62%)suffered ROP,4 cases(7.69%)suffered IVH,3 cases(5.77%)suffered NEC,and 2 cases(3.85%)died.Among children with aminophylline,14 cases(20.29%)suffered BPD,4 cases(5.80%)suffered ROP,2 cases(2.90%)suffered IVH,4 cases(5.80%)suffered NEC,and 2 cases(2.90%)died.There was no significant difference in the incidence of BPD,ROP,IVH,NEC and death between the two groups,the P values were all above 0.05.5.The developmental quotient of the two groups of children at 1 year corrected age was 93.24±7.88 and 90.35±7.57,t=1.825,P=0.071,there was no statistical difference.Conclusions:1.Caffeine citrate and aminophylline have similar efficacy in the treatment of primary apnea in preterm infants,and the incidence of complications is similar,but caffeine citrate is safer,and the rate of tachycardia and feeding intolerance is lower.2.The two groups show no difference in the overall neurological developmental outcome of children at 1 year corrected age. |
PDF Full Text Request