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目的研究茶碱治疗早产儿呼吸暂停的量效关系,为临床呼吸暂停早产儿合理应用茶碱类药物提供参考。方法回顾分析我院近两年来采用荧光偏振免疫分析法测定的67例呼吸暂停早产儿血清茶碱浓度及其使用的氨茶碱剂量。结果呼吸暂停早产儿的血清茶碱浓度与剂量呈正相关,但个体之间差异较大;临床疗效较好的氨茶碱日维持剂量为(2.9±0.8)mg.kg-1.d-1,相应的质量浓度为(4.3±1.1)mg.L-1;血清茶碱浓度与矫正胎龄无关,相关系数r=0.05(P>0.05),而茶碱日维持剂量与矫正胎龄显著相关,相关系数r=0.27(P<0.05)。结论临床上在使用茶碱治疗早产儿呼吸暂停时,应监测血药浓度并实行个体化给药,建议血清茶碱浓度维持在4 mg.L-1左右。
Objective To study the dose-response relationship of theophylline for apnea in preterm infants and to provide a reference for rational use of theophylline in premature infants with clinical apnea. Methods A retrospective analysis of our hospital in the past two years using fluorescence polarization immunoassay of 67 cases of apnea preterm children serum theophylline concentration and its use of aminophylline dose. Results Serum theophylline concentration was positively correlated with dose in preterm infants with apnea, but there was a significant difference between the two groups. The daily dose of aminophylline with good clinical efficacy was (2.9 ± 0.8) mg.kg-1.d-1, The corresponding concentration was (4.3 ± 1.1) mg.L-1. Serum theophylline concentration had no correlation with corrected gestational age, the correlation coefficient was 0.05 (P> 0.05), while the theophylline daily maintenance dose was significantly correlated with corrected gestational age The correlation coefficient r = 0.27 (P <0.05). Conclusion In the clinical use of theophylline in the treatment of apnea in preterm infants, the plasma concentration should be monitored and administered individually. The serum theophylline concentration should be maintained at about 4 mg.L-1.