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目的:评价不同剂量的枸橼酸咖啡因对早产儿呼吸暂停(AOP)的疗效和安全性;方法:检索中英文数据库,收集关于不同剂量枸橼酸咖啡因治疗早产儿呼吸暂停的随机对照试验。采用Review Manager 5.3软件对纳入的文献进行系统评价。结果:共纳入7篇文献,879例患者。Meta分析结果显示,高剂量的枸橼酸咖啡因显著降低撤机失败率[RR=0.65,95%CI(0.46,0.82),P=0.001];不同的枸橼酸咖啡因剂量组在院内病死率方面无显著差异[RR=0.76,95%CI(0.44,1.33),P=0.34];高剂量组具有更低的支气管肺发育不良发生率[RR=0.72,95%CI(0.58,0.89),P=0.003],同时显著增加心动过速的发生率[RR=2.36,95%CI(1.53,3.65),P=0.0001]。结论:现有证据提示,高剂量枸橼酸咖啡因用于早产儿呼吸暂停有更好的疗效,但有增加不良反应的风险。鉴于纳入研究较少且缺少远期评价,仍需更多的随机对照试验。
Objective: To evaluate the efficacy and safety of different doses of citrate caffeine on apnea (AOP) in preterm infants.Methods: The Chinese and English databases were searched to collect randomized controlled trials on different doses of citrate caffeine in the treatment of apnea in preterm infants . Reviewers 5.3 software was used to systematically evaluate the included literature. Results: A total of 7 articles were included, 879 patients. Meta-analysis showed that high dose of citrate caffeine significantly reduced the failure rate of weaning (RR = 0.65,95% CI (0.46, 0.82), P = 0.001]; different doses of citrate caffeine died in the hospital The rates of bronchopulmonary dysplasia were lower in the high-dose group (RR = 0.72, 95% CI, 0.58, 0.89) , P = 0.003], while significantly increasing the incidence of tachycardia [RR = 2.36,95% CI (1.53,3.65), P = 0.0001]. CONCLUSIONS: The available evidence suggests that high-dose caffeine citrate has better efficacy for apnea in preterm infants but at increased risk for adverse reactions. Given the few studies included and the lack of long-term evaluation, more randomized controlled trials are still needed.