Fang S, Sherwood R A, Gamsu H R, Marsden J T, Peters T J, Greenough A
Department of Child Health, King's College Hospital, London, UK.
Eur J Pediatr. 1998 May;157(5):406-9. doi: 10.1007/s004310050840.
Theophylline administration has been shown to attenuate erythropoietin (EP) production in adults; the effect of caffeine is not known. Our aim was to determine whether caffeine and theophylline had similar effects on EP production in the premature newborn. If caffeine was found to have a greater effect, this would influence prescribing habits. Fifty preterm infants (mean gestational age 28 weeks) who had clinically significant apnoea were randomized to receive theophylline (4 mg/kg then 2 mg/kg twice daily) or caffeine (10 mg/kg then 2.5 mg/kg once daily). The methylxanthines were continued at least until discharge from the NICU and the dosage altered to keep the levels within the therapeutic range. As an assessment of EP production, serum EP concentrations were measured. Blood for EP, haemoglobin, reticulocyte count, theophylline and caffeine levels was obtained prior to treatment and at least during weeks 3 and 7. There was no significant difference in the mean EP level in the two groups taken prior to treatment at a median age of 2 days of life. There were similar falls in haematocrit and haemoglobin in the two groups during the study period compared to pre-treatment values. At that time, however, the median reticulocyte count was higher in the caffeine compared to the theophylline treated infants (P < 0.05). This was associated with a rise compared to baseline (median 10.0-0.2 mU/ml) in the mean EP levels in the caffeine group and a decrease from a median of 10.1 to 8.3 mU/ml in the theophylline group, but the EP levels in the two groups at week 7 did not differ significantly.
These results suggest that caffeine does not have a greater impact than theophylline on EP production.
已证明氨茶碱给药可减弱成年人促红细胞生成素（EP）的产生；咖啡因的作用尚不清楚。我们的目的是确定咖啡因和氨茶碱对早产儿EP产生是否有相似的作用。如果发现咖啡因有更大的作用，这将影响处方习惯。50名患有临床上显著呼吸暂停的早产儿（平均胎龄28周）被随机分为接受氨茶碱（4mg/kg然后每日两次2mg/kg）或咖啡因（10mg/kg然后每日一次2.5mg/kg）。甲基黄嘌呤持续使用至少至从新生儿重症监护病房出院，并且调整剂量以保持水平在治疗范围内。作为对EP产生的评估，测量血清EP浓度。在治疗前以及至少在第3周和第7周期间获取用于检测EP、血红蛋白、网织红细胞计数、氨茶碱和咖啡因水平的血液。在出生后2天的中位年龄时，两组治疗前的平均EP水平没有显著差异。与治疗前值相比，在研究期间两组的血细胞比容和血红蛋白有相似的下降。然而，此时，与接受氨茶碱治疗的婴儿相比，接受咖啡因治疗的婴儿的中位网织红细胞计数更高（P<0.05）。这与咖啡因组平均EP水平相对于基线（中位值10.0 - 0.2mU/ml）的升高以及氨茶碱组从10.1的中位值降至8.3mU/ml相关，但两组在第7周时的EP水平没有显著差异。
这些结果表明咖啡因对EP产生的影响并不比氨茶碱大。
