长期监测胃内pH值以确定危重新生儿（早产儿和足月儿）雷尼替丁的最佳剂量。
Long-term gastric pH monitoring for determining optimal dose of ranitidine for critically ill preterm and term neonates.
作者信息
Kuusela A L
机构信息
Department of Paediatrics, University of Tampere Medical School, Finland.
出版信息
Arch Dis Child Fetal Neonatal Ed. 1998 Mar;78(2):F151-3. doi: 10.1136/fn.78.2.f151.
AIM
To determine the optimal doses of ranitidine for both preterm and term infants.
METHOD
The effect of ranitidine treatment was measured from the long-term intraluminal gastric pH in 16 preterm (gestational age under 37 weeks) and term infants treated in neonatal intensive care. The infants received three different bolus doses of ranitidine: 0.5 mg, 1.0 mg, and 1.5 mg per kilogram of body weight to keep the intraluminal gastric pH above 4 on a 24 hour basis.
RESULTS
Critically ill neonates, including very low birth weight infants, were capable of gastric acid formation, and ranitidine treatment increased the intraluminal gastric pH. The effect of a single dose lasted longer in preterm than in term infants. The time needed for reaching the maximum gastric pH was significantly longer in preterm than in term infants. The ranitidine given correlated with the duration of increased gastric pH in a dose dependent manner both in preterm and term infants.
CONCLUSION
Preterm infants need significantly smaller doses of ranitidine than term neonates to keep their intraluminal gastric pH over 4. The required optimal dose of ranitidine for preterm infants is 0.5 mg/kg/body weight twice a day and that for term infants 1.5 mg/kg body weight three times a day.
目的
确定雷尼替丁用于早产儿和足月儿的最佳剂量。
方法
通过测量16名在新生儿重症监护室接受治疗的早产儿（胎龄小于37周）和足月儿的长期胃内pH值，来评估雷尼替丁治疗的效果。这些婴儿接受了三种不同剂量的雷尼替丁推注：每公斤体重0.5毫克、1.0毫克和1.5毫克，以使胃内pH值在24小时内保持在4以上。
结果
包括极低出生体重儿在内的危重新生儿能够产生胃酸，雷尼替丁治疗可提高胃内pH值。单剂量的效果在早产儿中持续的时间比足月儿更长。早产儿达到最大胃pH值所需的时间明显长于足月儿。在早产儿和足月儿中，给予的雷尼替丁剂量与胃pH值升高的持续时间呈剂量依赖性相关。
结论
与足月儿相比，早产儿维持胃内pH值高于4所需的雷尼替丁剂量要小得多。早产儿所需的雷尼替丁最佳剂量为每天两次，每次0.5毫克/千克体重；足月儿为每天三次，每次1.5毫克/千克体重。
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