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目的探讨不同剂型氨茶碱治疗毛细支气管炎的疗效及依从性。方法毛细支气管炎患儿122例随机分为A、B、C3组。A组41例,予氨茶碱针剂,每次4 mg.kg-1,每8 h 1次,静脉滴注;B组41例,首次给予氨茶碱针剂4 mg.kg-1,同时加茶碱缓释胶囊口服,2次.d-1;C组40例,予氨茶碱片剂,每次4 mg.kg-1,3次.d-1。用药期间动态监测各组患儿血氨茶碱峰浓度和谷浓度,并记录患儿喘憋缓解时间、住院天数等。结果 A组、B组患儿喘憋缓解时间、住院天数比较差异均无统计学意义(Pa>0.05)。A组75.6%血药峰质量浓度为10～20 mg.L-1,B组78.0%血药峰质量浓度为5～10 mg.L-1,C组45.0%血药峰质量浓度<5 mg.L-1;血药谷质量浓度A组58.5%患儿、B组87.8%为5～10 mg.L-1,C组85.0%<5 mg.L-1。A组、B组疗效均优于C组,但A组不良反应较B组和C组明显,依从性差,血药峰质量浓度和谷质量浓度波动较大。结论首剂给予氨茶碱针剂负荷量加氨茶碱缓释剂口服治疗毛细支气管炎疗效明显,不良反应少,依从性好。
Objective To investigate the efficacy and compliance of different forms of aminophylline in the treatment of bronchiolitis. Methods 122 children with bronchiolitis were randomly divided into A, B and C3 groups. A group of 41 cases, to aminophylline injection, each 4 mg.kg-1, every 8 h 1, intravenous drip; B group 41 cases, the first given aminophylline injection 4 mg.kg-1, plus Theophylline sustained-release capsules orally, 2 times .d-1; C group 40 cases, to aminophylline tablets, each 4 mg.kg-1, 3 times .d-1. During the treatment, the peak concentrations and the trough concentrations of blood methamidophos in each group were monitored dynamically, and the time for remission and the days of hospitalization were recorded. Results There was no significant difference between the two groups (Pa> 0.05). A group of 75.6% peak plasma concentration of 10 ~ 20 mg.L-1, B group 78.0% peak plasma concentration of 5 ~ 10 mg.L-1, C group 45.0% peak plasma concentration of <5 mg .L-1; 58.5% of children in group A had a mass concentration of 87.5% in group B, 5 to 10 mg.L-1 in group B and 85.0% <5 mg.L-1 in group C. The efficacy of group A and group B was better than that of group C, but the adverse reaction of group A was more obvious than group B and group C, and the compliance was poor. The peak plasma concentration and valley quality fluctuated greatly. Conclusion The first dose of aminophylline injection and aminophylline sustained-release agent oral treatment of bronchiolitis obvious effect, less adverse reactions, good compliance.