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早期口服布洛芬对极低出生体重儿动脉导管未闭的治疗效果

[Therapeutic effect of early administration of oral ibuprofen in very low birth weight infants with patent ductus arteriosus].

作者信息

Lin Xin-Zhu, Chen Han-Qiang, Zheng Zhi, Li Ya-Dan, Lai Ji-Dong, Huang Li-Han

机构信息

Department of Neonatology, Maternal and Child Health Hospital of Xiamen City, Xiamen, Fujian 361000, China.

出版信息

Zhongguo Dang Dai Er Ke Za Zhi. 2012 Jul;14(7):502-5.

Abstract

OBJECTIVE

To study therapeutic effect and safety of early administration of oral ibuprofen in very low birth weight infants (VLBWIs) with patent ductus arteriosus (PDA).

METHODS

A total of 64 symptomatic VLBWIs (within 24 hours after birth) with PDA confirmed by bedside Color Doppler ultrasound were randomly divided into two groups: treatment and control (n=32 each). The treatment group was orally administered ibuprofen within 24 hours after birth at 10 mg/kg, followed 24 hours later by a second dose of 5 mg/kg and 48 hours later by a third dose of 5 mg/kg. The control group was treated with placebo (normal saline) at 1 mL/kg, followed 24 hours later by a second dose of 0.5 mL/kg and 48 hours later by a third dose of 0.5 mL/kg. The therapeutic efficacies and adverse effects in both groups were observed.

RESULTS

The treatment group showed a significantly higher closure rate of ductus arterious than the control group after one course of treatment (84% vs 41%; P<0.01). The incidence rates of periventricular leukomalacia and bronchopulmonary dysplasia were significantly lower in the treatment group than in the control group (P<0.05). The duration of mechanical ventilation and mean hospitalization time were significantly shorter in the treatment group than in the control group (P<0.05). There were no significant differences in the incidence rates of intraventricular hemorrhage, early pulmonary hemorrhage and necrotizing enterocolitis between the two groups (P>0.05). No obvious adverse effects were observed in both groups.

CONCLUSIONS

Early administration of oral ibuprofen for treatment of PDA in VLBWIs can decrease the incidence rates of some early complications and shorten hospitalization time, but causes no significant adverse effects.

摘要

目的

研究早期口服布洛芬对极低出生体重儿(VLBWIs)动脉导管未闭(PDA)的治疗效果及安全性。

方法

选取64例经床边彩色多普勒超声确诊为PDA的有症状VLBWIs(出生后24小时内),随机分为治疗组和对照组,每组32例。治疗组在出生后24小时内口服布洛芬,剂量为10mg/kg,24小时后给予第二剂5mg/kg,48小时后给予第三剂5mg/kg。对照组给予安慰剂(生理盐水),剂量为1mL/kg,24小时后给予第二剂0.5mL/kg,48小时后给予第三剂0.5mL/kg。观察两组的治疗效果及不良反应。

结果

治疗组经过一个疗程治疗后动脉导管闭合率显著高于对照组(84%对41%;P<0.01)。治疗组脑室周围白质软化和支气管肺发育不良的发生率显著低于对照组(P<0.05)。治疗组机械通气时间和平均住院时间显著短于对照组(P<0.05)。两组脑室内出血、早期肺出血和坏死性小肠结肠炎的发生率无显著差异(P>0.05)。两组均未观察到明显不良反应。

结论

早期口服布洛芬治疗VLBWIs的PDA可降低一些早期并发症的发生率,缩短住院时间,且无明显不良反应。

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