咖啡因治疗早产儿呼吸暂停的研究进展

早产儿呼吸暂停（AOP）是新生儿重症监护中最常见的临床问题之一,持续的呼吸暂停会对脑部及器官发育产生长期危害。咖啡因的安全剂量范围大,不良反应小,半衰期长,是治疗AOP的首选药物。到目前为止,对于咖啡因治疗的最佳剂量和时机还没有达成共识的标准化方案,需在临床观察的基础上进行剂量调整。目前可通过血药浓度监测、建立群体药代动力学模型、评估CYP1A2酶的活性,以及对酶基因多态性进行分析等方法指导咖啡因的剂量调整,预测血药浓度,为临床合理用药提供参考,实现临床个体化用药。

Research Progress on Accurate Use of Caffeine in the Treatment of Apnea in Premature Infants

Apnea of prematurity (AOP) is one of the most common clinical problems in neonatal intensive care. Persistent apnea will cause long-term harm to the development of brain and organs. Caffeine has a wide range of safe doses, mild adverse reactions and long half-life, so it is the first choice for the treatment of AOP. But so far, there is no consensus on optimal dose and timing of caffeine treatment, and dose adjustment is needed on the basis of clinical observation. At present, caffeine dose adjustment can be guided by monitoring blood drug concentrations, establishing population pharmacokinetic models, evaluating CYP1A2 enzyme activities and analyzing enzyme gene polymorphisms, so as to predict blood drug concentration and provide reference to achieve clinical accurate drug use.