Hamilcikan Sahin, Can Emrah, Buke Ovgu, Polat Can, Ozcan Esra
University of Health Sciences Bagcilar Training and Research Hospital, Istanbul, Turkey.
J Pak Med Assoc. 2017 Oct;67(10):1482-1486.
To compare different support therapies in very low birth-weight preterm neonates with nosocomial sepsis.
This clinical pilot study was conducted at the Bagcilar Research and Training Hospital, Istanbul, Turkey, from September 2015 to November 2016. Preterm infants appropriately sized for a gestational age of < 32 weeks and < 1,500g were included in the study. Pentaglobin was initiated on the day of diagnosis of nosocomial sepsis to very low birth-weight preterm neonates as a support therapy in addition to antibiotics: 5 ml/kg per day of pentaglobin was infused over a four-hour period on three consecutive days. Pentoxifylline (5 mg/kg every 6 hours) was administered to premature infants with sepsis on three successive days.
Of the 41 neonates, 19(46.3%) were girls and 22(53.7%) were boys. Vital signs, haematologic tables, peripheral blood smear left shift ratio, and blood-gas parameters did not differ significantly between the groups (p>0.05), but the C-reactive protein (mg/dl) values significantly decreased after pentoxifylline treatment (p<0.05). Coagulase-negative staphylococci were the most frequently isolated bacteria in the two groups (n=4; 19% vs. n=4; 20%). There was no difference in isolated microorganisms. There was no significant difference in intraventricular haemorrhage, necrotising enterocolitis, periventricular leukomalacia or symptomatic patent ductus arteriosus in the neonates when comparing the two groups and no systemic reactions were observed during adjuvant therapy in the preterm neonates (p>0.05). The total duration of hospitalisation was 49.46±13.52 days for the pentaglobin group and 44.21±11.1 days for the pentoxifylline group neonates.
Pentoxifylline treatment for nosocomial sepsis decreased C-reactive protein levels and heart rate more than pentaglobin therapy.
比较极低出生体重早产新生儿医院感染性败血症的不同支持治疗方法。
本临床试点研究于2015年9月至2016年11月在土耳其伊斯坦布尔的巴伊西拉尔研究与培训医院进行。纳入胎龄<32周、体重<1500g的早产婴儿。除抗生素外，在医院感染性败血症诊断当天开始对极低出生体重早产新生儿使用潘托希灵作为支持治疗：连续三天，每天5ml/kg的潘托希灵在4小时内输注完毕。对败血症早产儿连续三天给予己酮可可碱（每6小时5mg/kg）。
41例新生儿中，19例（46.3%）为女孩，22例（53.7%）为男孩。两组之间的生命体征、血液学指标、外周血涂片左移率和血气参数无显著差异（p>0.05），但己酮可可碱治疗后C反应蛋白（mg/dl）值显著降低（p<0.05）。凝固酶阴性葡萄球菌是两组中最常分离出的细菌（n=4；19%对n=4；20%）。分离出的微生物无差异。比较两组新生儿时，脑室内出血、坏死性小肠结肠炎、脑室周围白质软化或有症状的动脉导管未闭无显著差异，且在早产儿辅助治疗期间未观察到全身反应（p>0.05）。潘托希灵组新生儿的住院总时长为49.46±13.52天，己酮可可碱组为44.21±11.1天。
对于医院感染性败血症，己酮可可碱治疗比潘托希灵治疗更能降低C反应蛋白水平和心率。
