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目的:探讨不同维持量枸橼酸咖啡因对早产儿原发性呼吸暂停(AOP)的疗效.方法:选择2015年12月至2017年4月潍坊市人民医院新生儿科收治的胎龄2834周的AOP患儿共128例,随机分为治疗组和对照组各64例.两组患儿均给予一般治疗和枸橼酸咖啡因首剂20 mg/kg,对照组治疗24 h后枸橼酸咖啡因维持量5 mg/(kg·d),治疗组治疗24 h后枸橼酸咖啡因维持量10 mg/(kg·d),均为每日静脉注射1次,应用至呼吸暂停停止发作后7 d.比较两组患儿临床疗效、呼吸暂停发作频次、呼吸暂停消失时间、用药时间、呼吸机使用情况及不良反应发生情况等.结果:治疗组用药1 d后的呼吸暂停发作频率为(3.4±1.1)次/天,呼吸暂停消失时间为(2.7±0.8)d,用药时间为(9.8±0.5)d,上机时间为(3.1±0.7)d;对照组药1 d后呼吸暂停发作频率为(5.4±1.5)次/天,呼吸暂停消失时间为(4.5±2.2)d,用药时间为(11.6±0.9)d,上机时间为(5.8±1.5)d,两组比较差异均有统计学意义(P＜0.05),且两组不良反应发生率比较差异无统计学意义(P＞0.05).结论:枸橼酸咖啡因治疗AOP时,大剂量较一般维持量更有效,且不良反应发生情况未见明显增加.“,”Objective: To investigate the efficacy of different maintenance doses of caffeine citrate in the treatment of apnea of prematurity ( AOP) . Methods: One hundred and twenty-eight children with AOP from 28 to 34 weeks of gestational age admitted into Weifang People's Hospital from Dec. 2015 to Apr. 2017 were extracted to be randomly divided into treatment group and control group, with 64 cases in each. Both groups were given general treatment and the first dose of 20 mg/kg of caffeine; the control group was treated with the maintenance dose of 10 mg/ (kg·d) after 24 hours, and the treatment group received the maintenance dose of 10 mg/ ( kg·d) after 24 hours, all children were injected intravenously once a day until 7 days after the onset of apnea. The clinical efficacy, frequency of apnea episodes, disappeared time of apnea, administration time, application of ventilator and incidence of adverse drug reactions of two groups were compared. Results: The frequency of apnea episodes, disappeared time of apnea, administration time and application time of ventilator in treatment group after administration time of 1 d were respectively (3.4±1.1) times/d, (2.7±0.8) d, (9.8±0.5) d and (3.1±0.7) d; while these data in control group were respectively (5.4±1.5) times/d, (4.5±2.2) d, (11.6±0.9) d and (5.8±1.5) d; the differences were statistically significant between two groups ( P ＜ 0.05) . The incidence of adverse drug reactions of two groups was not statistically significant ( P＞0.05) . Conclusion: High dose of caffeine citrate in treatment of AOP is more effective than the general maintenance, and the incidence of adverse drug reactions has not increased significantly.