摘要
目的:探讨婴儿氨茶碱急性中毒的临床诊治及其药物代谢动力学.方法:4例怀疑急性氨茶碱中毒的急诊收入住院治疗的婴儿和1例新生儿,应用荧光偏振免疫方法测定其茶碱血药浓度.结果:5例患儿临床症状有烦躁不安、痉挛以及惊厥等(其中2例出现呕吐),呼吸次数为每分钟50～80次,心率为每分钟145～212次.急诊立即测定其茶碱血药浓度均超过20mg·L-1.确诊为氨茶碱急性中毒,采取对症治疗,ld后茶碱血药浓度均低于15mg·L-1,4例婴儿治疗3d中毒症状消失,1例新生儿治疗8d中毒症状才缓解.4例婴儿和1例新生儿氨茶碱急性中毒的t1/2分别为18.0±2.1h和44.5h.结论:婴儿使用氨茶碱的个体化剂量和给药途径应引起各级医护人员的高度重视.血药浓度监测与临床症状相结合,是确诊氨茶碱中毒的特征指标.对症治疗对婴儿氨茶碱血药浓度低于40mg·L1急性中毒是有效的.结果表明,婴儿在氨茶碱急性中毒时,其消除t1/2显著增大.
OBJECTIVE: The diagnosis and treatment of acute aminophyllinepoisoning and it's pharmacokinetics in infants. METHODS:4 cases young childrenand l case infant newborn with acute aminophyliine poisoning were managed inour hospital. Serum theophylline concentration was determined by fluorescencepolarization immunoassay (FPIA). RESULTS: Common clinical toxic symptoms ofacute aminophylline poisoning may include dysphoria, dysmyotonia, seizures, shortof breath (range from 50 to 80min-1) and tachyrhythmia (range from l45 to2l2min-1). All serum theophylline concentrations exceed20mg.L-1 in emergencydepartment. The diagnosis was acute aminophylline poisoning. The treatmentwas symptomatic and supportive. The decrease of serum theophylline levelswas l5mg.L-1 in 24 hours during therapeutic, clinical toxic symptoms were alsoreleased. The toxicokinetic parameters of acute aminophylline poisoning t(1/2)were18.0±2.lh and 44.5h for 4 cases infants and l case infant newbornrespectively. CONCLUSINS: Pay attention to the individualizing dosage and routesof aminophylline administration in infants. TDM and clinical symptoms help tojudge diagnosis and progress of theophylline intoxication, response to therapy,and the need for additional treatment. Symptomatic and supportive therapy, as inother medical emergencies, is the most important aspect of the treatment ofacute theophylline poisoning.The results show that the t(l/2)of theophyllineintoxication has been increased compared with nonpoisoner in infants.
出处
《中国临床药理学杂志》
CAS
CSCD
北大核心
2002年第2期145-148,共4页
The Chinese Journal of Clinical Pharmacology
关键词
婴儿
氨茶碱
急性中毒
诊断
治疗
药动学
infant
aminophylline
acute poisoning
diagnosis and treatment
pharmacokinetic
