Lauterbach Ryszard, Szymura-Oleksiak Joanna, Pawlik Dorota, Warchoł Jolanta, Lisowska-Miszczyk Ilona, Rytlewski Krzysztof
Department of Neonatology, Jagiellonian University Medical College, Kraków, Poland.
J Matern Fetal Neonatal Med. 2006 Jul;19(7):433-8. doi: 10.1080/14767050600736754.
To evaluate the effectiveness of nebulized pentoxifylline (PTXF) compared to intravenous dexamethasone (DX) or placebo (nebulized distilled water) for the prevention of bronchopulmonary dysplasia (BPD).
One hundred and fifty very low birth weight infants were randomly assigned to three groups. Entry criteria were the need for oxygen administration on the fourth day of life, irrespective of whether ventilatory support was required. PTXF was administered with a nebulizer every 6 hours on three consecutive days (a single course) in a dose of 20 mg/kg when infants were breathing spontaneously or 10 mg/kg when they needed ventilatory support. DX was given every 12 hours on three consecutive days in a dose of 0.25 mg/kg. Nebulized distilled water was administered with the schedule of inhalation as in the PTXF group. When the need for ventilatory support or oxygen dependency persisted, the course of both drugs and placebo administration was repeated every seven days until the diagnosis of BPD was established.
Both PTXF and DX reduced the incidence of disease when compared with placebo. The respective data obtained for the PTXF-group versus the placebo group were as follows: difference in risk, 27%; OR: 0.32; CI: 0.11-0.94; p = 0.039; whereas the results for the DX-group versus the placebo group were: difference in risk, - 23%; OR: 0.39; CI: 0.14-1.14; p = 0.07.
Our data show that nebulized PTXF reduces the risk of BPD and may be a potential alternative to steroids in the prevention of this disease.
评估雾化吸入己酮可可碱（PTXF）与静脉注射地塞米松（DX）或安慰剂（雾化蒸馏水）相比，在预防支气管肺发育不良（BPD）方面的有效性。
150例极低出生体重儿被随机分为三组。入选标准为出生后第4天需要吸氧，无论是否需要通气支持。当婴儿自主呼吸时，PTXF用雾化器每6小时给药一次，连续三天（一个疗程），剂量为20mg/kg；当需要通气支持时，剂量为10mg/kg。DX连续三天每12小时给药一次，剂量为0.25mg/kg。雾化蒸馏水的吸入方案与PTXF组相同。当通气支持或氧依赖持续存在时，两种药物和安慰剂的给药疗程每七天重复一次，直到确诊为BPD。
与安慰剂相比，PTXF和DX均降低了疾病发生率。PTXF组与安慰剂组的相应数据如下：风险差异为27%；OR：0.32；CI：0.11 - 0.94；p = 0.039；而DX组与安慰剂组的结果为：风险差异为 - 23%；OR：0.39；CI：0.14 - 1.14；p = 0.07。
我们的数据表明，雾化吸入PTXF可降低BPD的风险，在预防该疾病方面可能是类固醇的潜在替代药物。
