Section of Neonatology, Department of Pediatrics, University of Calgary, Calgary, Canada.
Am J Perinatol. 2013 Oct;30(9):745-50. doi: 10.1055/s-0032-1332800. Epub 2013 Jan 15.
To compare the incidence of medical closure of patent ductus arteriosus (PDA) and adverse events (acute renal dysfunction, necrotizing enterocolitis, spontaneous intestinal perforation, and gastrointestinal bleeding) between preterm infants who received indomethacin and ibuprofen for the treatment of PDA.
A retrospective comparative effectiveness evaluation study was conducted on preterm infants (≤32 weeks) who received indomethacin or ibuprofen for treatment of symptomatic PDA.
Of the 124 eligible infants, 54 received indomethacin and 70 received ibuprofen. The overall incidence of medical PDA closure with indomethacin was 37/54 (68.5%) as compared with 42/70 (60%) in the ibuprofen group (p = 0.32). The proportion of infants with surgical PDA ligation was similar between the two groups (18.5% in both the groups). There was no difference in the incidences of acute renal dysfunction, necrotizing enterocolitis stage ≥ 2, spontaneous intestinal perforation, and gastrointestinal bleeding between indomethacin and ibuprofen groups.
Ibuprofen is as effective as indomethacin in the treatment of symptomatic PDA in preterm infants. This study also shows that both agents have similar adverse effects and the choice of one agent over the other should be based on local availability and dosing preference.
比较接受吲哚美辛和布洛芬治疗动脉导管未闭（PDA）的早产儿中，PDA 内科闭合的发生率和不良事件（急性肾功能障碍、坏死性小肠结肠炎、自发性肠穿孔和胃肠道出血）。
对接受吲哚美辛或布洛芬治疗症状性 PDA 的早产儿（≤32 周）进行回顾性比较有效性评估研究。
124 名符合条件的婴儿中，54 名接受吲哚美辛治疗，70 名接受布洛芬治疗。吲哚美辛组内科 PDA 闭合的总发生率为 37/54（68.5%），而布洛芬组为 42/70（60%）（p=0.32）。两组的手术 PDA 结扎率相似（两组均为 18.5%）。吲哚美辛组和布洛芬组在急性肾功能障碍、≥2 期坏死性小肠结肠炎、自发性肠穿孔和胃肠道出血的发生率方面无差异。
布洛芬在治疗早产儿症状性 PDA 方面与吲哚美辛同样有效。本研究还表明，两种药物的不良反应相似，应根据当地的供应情况和剂量偏好选择一种药物而不是另一种药物。
