Segawa H, Iikura Y
Department of Pediatrics, Jikei University School of Medicine.
Arerugi. 1990 Oct;39(10):1427-36.
This study examined the relationship between long-term theophylline therapy and behavior problems in 14 asthmatic children that includes 5 intractable cases and 24 non-asthmatic children. Asthmatic children have received theophylline therapy and cromolyn inhalation for 3.6 +/- 3.8 years. Subjects were tested on neuropsychologic batteries; behavior problems and personality of children questionnaire, child behavior checklist, caffeine-like side effects questionnaire, manifest anxiety scale, visual attention test, Uchida-Kraepelin test and soft neurological signs. These tests were repeated with an interval of 1 to 12 weeks. Parents noted caffeine-like side effects, stomach ache and difficulty in sleeping, in their child during the theophylline therapy. The caffeine-like side effects decreased after stopping theophylline therapy. The rate of mistake in Uchida-Kraepelin test for the asthmatic group and for the intractable cases was significantly higher than that of the control group. Time of the sequential finger thumb opposition of the soft neurological signs was significantly prolonged in asthmatic group. There was no significant change in the other tests between asthmatic and non-asthmatic children and before and after stopping theophylline therapy. It seems that behavior problems and learning disability observed in the asthmatic children are due to the pathogenesis or symptoms of asthma rather than the effect of long-term theophylline therapy.
本研究调查了14名哮喘儿童(其中包括5名难治性病例)长期使用茶碱治疗与行为问题之间的关系,并与24名非哮喘儿童进行了对比。哮喘儿童接受茶碱治疗和色甘酸钠吸入治疗的时间为3.6±3.8年。对受试者进行了神经心理测试;儿童行为问题与个性问卷、儿童行为清单、咖啡因样副作用问卷、显性焦虑量表、视觉注意力测试、内田-克雷佩林测验和软性神经体征检查。这些测试每隔1至12周重复进行一次。家长们注意到,在孩子接受茶碱治疗期间出现了咖啡因样副作用、胃痛和睡眠困难等情况。停止茶碱治疗后,咖啡因样副作用有所减轻。哮喘组和难治性病例组在内田-克雷佩林测验中的错误率显著高于对照组。哮喘组软性神经体征中顺序对指的时间显著延长。在其他测试中,哮喘儿童与非哮喘儿童之间以及停止茶碱治疗前后均无显著变化。哮喘儿童中观察到的行为问题和学习障碍似乎是由哮喘的发病机制或症状引起的,而非长期茶碱治疗的影响。