Laubscher B, Greenough A, Dimitriou G
Dept of Child Health, King's College Hospital, London, UK.
Early Hum Dev. 1998 Jan 9;50(2):185-92. doi: 10.1016/s0378-3732(97)00038-6.
The aim of this study was to determine the relative effects of theophylline and caffeine on neonatal respiratory function. Fifty-three preterm infants (45 infants with a median gestational age of 28 weeks, range 24-34 weeks completed the protocol) were randomized to receive either theophylline (loading dose 4 mg/kg followed by 4 mg/kg/day) or caffeine (loading dose 10 mg/kg followed by 5 mg/kg/day). Compliance of the respiratory system (CRS), strength of Hering Breuer reflex and the inspired oxygen concentration requirement were measured immediately prior to, 24 h and 7 days after commencing therapy. There was no statistically significant difference in the patient characteristics of the two groups, but only the theophylline group contained immature infants (i.e. < 26 weeks gestational age (n = 7)). At 24 h, there was a significant improvement in CRS and reduction in supplementary oxygen requirements in the caffeine group (p < 0.01), in the theophylline group no such significant effects were seen. In the study population overall, after 7 days of treatment in both the theophylline and caffeine groups there was an improvement in CRS (p < 0.05 and p < 0.01 respectively) and a reduction in the inspired oxygen concentration (p < 0.05 and p < 0.01 respectively). There was, however, a significant reduction in the strength of the Hering Breuer reflex only in the caffeine group (p < 0.05) and this was a decrease which related to the change in CRS (p < 0.05). The only statistically significant difference in the magnitude of change in CRS, reflex strength or supplementary oxygen requirements between the two groups was that the reduction in inspired oxygen requirement in the caffeine group was greater than that in the theophylline treated infants at 24 h (p < 0.05). We conclude theophylline and caffeine have similar effects on neonatal respiratory function, but our results suggest caffeine administration may be associated with an earlier onset of action.
本研究的目的是确定茶碱和咖啡因对新生儿呼吸功能的相对影响。53名早产儿（45名中位胎龄为28周、范围为24 - 34周的婴儿完成了方案）被随机分为接受茶碱（负荷剂量4mg/kg，随后4mg/kg/天）或咖啡因（负荷剂量10mg/kg，随后5mg/kg/天）治疗。在开始治疗前、治疗24小时和7天后，测量呼吸系统顺应性（CRS）、黑林-布雷尔反射强度和吸入氧浓度需求。两组患者特征无统计学显著差异，但只有茶碱组包含未成熟婴儿（即胎龄<26周（n = 7））。在24小时时，咖啡因组的CRS有显著改善，补充氧气需求减少（p < 0.01），而茶碱组未观察到此类显著效果。在整个研究人群中，茶碱组和咖啡因组治疗7天后，CRS均有改善（分别为p < 0.05和p < 0.01），吸入氧浓度降低（分别为p < 0.05和p < 0.01）。然而，仅咖啡因组的黑林-布雷尔反射强度有显著降低（p < 0.05），且这种降低与CRS的变化相关（p < 0.05）。两组之间在CRS变化幅度、反射强度或补充氧气需求方面唯一的统计学显著差异是，在24小时时，咖啡因组吸入氧需求的降低大于茶碱治疗的婴儿（p < 0.05）。我们得出结论，茶碱和咖啡因对新生儿呼吸功能有相似影响，但我们的结果表明，给予咖啡因可能与更早起效有关。
