不同剂量氨茶碱在极低出生体重儿中的药代动力学及药效学研究

发布时间：2018-01-23 10:29

本文关键词： 氨茶碱药代动力学药效学维持剂量极低出生体重儿　出处：《中国当代儿科杂志》2015年11期 　论文类型：期刊论文

【摘要】：目的探索不同剂量氨茶碱在不同校正胎龄、体重及日龄的极低出生体重儿中药代动力学和药效学特点。方法选取发生呼吸暂停的极低出生体重儿40例,予以负荷剂量(5 mg/kg)氨茶碱静脉注射后随机分为两组,分别给予不同维持剂量(1 mg/kg及2 mg/kg,每8 h给药一次)。在治疗后8 h、3 d、7 d监测血药浓度及肝肾功能,记录呼吸暂停发作情况,比较两组药代动力学数据。结果 2 mg/kg组的稳态血药浓度、血浆清除率明显高于1 mg/kg组,半衰期低于1 mg/kg组(P0.05)。2 mg/kg组患儿生后7 d内呼吸暂停发作天数明显较1 mg/kg组少(P0.05)。两组患儿的氨茶碱血浆清除率与生后日龄及校正胎龄呈正相关(P0.05)。结论极低出生体重儿中不同维持剂量氨茶碱药代动力学及药效学参数具有差异,2 mg/kg氨茶碱治疗呼吸暂停效果优于1 mg/kg;临床上对氨茶碱进行剂量调整时应考虑患儿校正胎龄及生后日龄,同时进行常规血药浓度监测。
[Abstract]:Objective to explore the pharmacokinetics and pharmacodynamics of different doses of aminophylline in very low birth weight infants with different corrected gestational age, body weight and day. Methods 40 cases of very low birth weight infants with apnea were selected. After intravenous injection of aminophylline at a loading dose of 5 mg / kg, the rats were randomly divided into two groups, with different maintenance doses of 1 mg/kg and 2 mg/kg, respectively. Blood concentration and liver and kidney function were monitored at 8 hours after treatment and apnea attack was recorded. Results the plasma clearance rate of mg/kg group was significantly higher than that of 1 mg/kg group. The days of apnea attack within 7 days after birth in the group of half life less than 1 mg/kg group were significantly less than that in the group of 1 mg/kg group (P 0.05). The plasma clearance rate of aminophylline in both groups was positively correlated with postnatal age and corrected gestational age (P0.05). Conclusion the pharmacokinetics and pharmacodynamic parameters of aminophylline in very low birth weight infants with different maintenance doses are different. 2 the effect of mg/kg aminophylline on apnea was better than that of 1 mg / kg; The corrected gestational age and postnatal age should be taken into account when adjusting the dosage of aminophylline in clinic, and the routine blood drug concentration should be monitored at the same time.
【作者单位】：四川大学华西第二医院儿科;
【基金】：国家临床重点专科建设项目(1311200003303) 成都市科技惠民项目(2014-HM01-00058-SP) 四川省科技厅科技支撑项目(2013SZ0028) 国家自然科学基金青年基金(81300524) 四川省卫生和计划生育委员会科研课题(150104) 四川省医学科研青年创新课题(Q14036)
【分类号】：R969.1
【正文快照】： 呼吸暂停是早产儿的常见并发症之一。胎龄越小、出生体重越轻,发生率越高。研究报道,胎龄小于34周的早产儿中呼吸暂停发生率约为85%[1-2]。反复发生的呼吸暂停可引起神经系统预后不良,若未能及时发现及处理,还可能导致患儿猝死[1,3-5]。因此,呼吸暂停的控制是早产儿呼吸管理的

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