氨茶碱对早产儿的代谢及呼吸作用
Metabolic and respiratory effects of theophylline in the preterm infant.
作者信息
Carnielli V P, Verlato G, Benini F, Rossi K, Cavedagni M, Filippone M, Baraldi E, Zacchello F
机构信息
Dipartimento di Pediatria, Via Giustiniani 3, 35128 Padova, Italy.
出版信息
Arch Dis Child Fetal Neonatal Ed. 2000 Jul;83(1):F39-43. doi: 10.1136/fn.83.1.f39.
BACKGROUND
Methylxanthines are often administered to preterm infants for the treatment of apnoea.
AIMS
To study the effects of theophylline on energy metabolism, physical activity, and lung mechanics in preterm infants.
METHODS
Indirect calorimetry was performed for six hours before and after administration of a bolus of theophylline (5 mg/kg) in 18 preterm infants while physical activity was recorded with a video camera. Lung mechanics measurements were performed at baseline and 12 and 24 hours after theophylline treatment.
RESULTS
Theophylline increased mean (SEM) energy expenditure by 15 (5) kJ/kg/day and augmented carbohydrate utilisation from 6.8 to 8.0 g/kg/day, but fat oxidation was unchanged. After theophylline treatment, preterm infants had faster respiration, lower transcutaneous CO2, and improved static respiratory compliance without increased physical activity.
CONCLUSIONS
A bolus of 5 mg/kg theophylline increased energy expenditure independently of physical activity, increased carbohydrate utilisation, and improved respiratory compliance. The increased energy expenditure could be detrimental to the growth of the preterm infant.
背景
甲基黄嘌呤常用于治疗早产儿呼吸暂停。
目的
研究氨茶碱对早产儿能量代谢、身体活动及肺力学的影响。
方法
对18例早产儿静脉注射氨茶碱（5mg/kg），注射前后各进行6小时的间接测热法测量，同时用摄像机记录身体活动情况。在基线水平以及氨茶碱治疗后12小时和24小时进行肺力学测量。
结果
氨茶碱使平均（标准误）能量消耗增加15（5）kJ/kg/天，碳水化合物利用率从6.8g/kg/天增至8.0g/kg/天，但脂肪氧化未变。氨茶碱治疗后，早产儿呼吸加快，经皮二氧化碳分压降低，静态呼吸顺应性改善，且身体活动未增加。
结论
静脉注射5mg/kg氨茶碱可独立于身体活动增加能量消耗，提高碳水化合物利用率，并改善呼吸顺应性。能量消耗增加可能对早产儿生长不利。
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