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因动脉导管过早闭合导致的心肌病病例:扑热息痛的另一面。

A Case of Cardiomyopathy Due to Premature Ductus Arteriosus Closure: The Flip Side of Paracetamol.

机构信息

Neonatal ICU, Azienda Ospedaliera Universitaria Policlinico "Paolo Giaccone," Department of Sciences for Health Promotion and Mother and Child Care "Giuseppe D'Alessandro," University of Palermo, Palermo, Italy

Neonatal ICU, Azienda Ospedaliera Universitaria Policlinico "Paolo Giaccone," Department of Sciences for Health Promotion and Mother and Child Care "Giuseppe D'Alessandro," University of Palermo, Palermo, Italy.

出版信息

Pediatrics. 2018 Feb;141(2). doi: 10.1542/peds.2016-3850. Epub 2018 Jan 17.

Abstract

Paracetamol (acetaminophen or N-acetyl-p-aminophenol) is considered a safe analgesic and antipyretic nonsteroidal antiinflammatory drug commonly used during pediatric ages and during pregnancy. We report on a term neonate with closed ductus arteriosus, severe cardiomyopathy, right ventricular dysfunction, and functional stenosis of pulmonary arteries at birth after maternal self-medication with paracetamol and consumption of polyphenol-rich foods in late pregnancy. This drug, especially when associated with other vasoconstrictors (such as polyphenols), interferes with prostaglandin metabolism, which seriously accentuates the intrauterine ductus arteriosus constriction and leads to pharmacologic adverse events. We suggest maternal educational programs to avoid risky self-medications and provide training for the best diets.

摘要

对乙酰氨基酚(醋氨酚或 N-乙酰对氨基酚)被认为是一种安全的镇痛解热非甾体抗炎药,常用于儿科和妊娠期。我们报告了一例足月新生儿,母亲在妊娠晚期自我用药对乙酰氨基酚和摄入富含多酚的食物后,出生时动脉导管未闭、严重心肌病、右心室功能障碍和肺动脉功能性狭窄。这种药物,尤其是与其他血管收缩剂(如多酚)联合使用时,会干扰前列腺素代谢,严重加剧宫内动脉导管收缩,导致药物不良反应。我们建议开展孕产妇教育计划,避免危险的自我用药,并提供最佳饮食培训。

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