Nishizaki Naoto, Matsuda Akina, Yoneyama Toshiyuki, Watanabe Akiko, Obinata Kaoru, Shimizu Toshiaki
Department of Pediatrics, Juntendo University Urayasu Hospital, Chiba, Japan.
Department of Pediatrics and Adolescent Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.
Pediatr Int. 2020 Feb;62(2):193-199. doi: 10.1111/ped.14057. Epub 2020 Feb 3.
Ibuprofen (IBU) has been used recently for the treatment of patent ductus arteriosus (PDA) in Japan. We aimed to investigate the efficacy and adverse events of IBU and compare them with those of indomethacin (IND) as PDA treatment for extremely low-birthweight infants (ELBWIs), focusing on short-term renal function.
A case-control study was conducted on 16 ELBWIs. The data from eligible patients were divided into two groups. Ten patients had undergone IND treatment (IND group) between January 2017 and June 2018, whereas six had undergone IBU treatment (IBU group) for PDA between July 2018 and December 2018. The IND group received 0.1 mg/kg/12h IND IV infusion for three doses, whereas the IBU group received 10 mg/kg IV IBU infusion followed by 5 mg/kg/day for 2 days. We compared the efficacy for PDA closure and renal impairment between the two groups.
No significant differences in primary closure rates and the PDA ligation required were observed between the two groups. No significant differences were observed between the incidence of intraventricular hemorrhage and gastrointestinal complications in both groups. Changes in urine volume (%) in the IBU group were significantly higher than in the IND group at 24-36 h post-administration. The urinary L-type fatty acid binding protein concentration level at 7 days of life was significantly lower in the IBU group than in the IND group.
Although IBU was comparable to IND in PDA closure rate, IBU was superior to short-term renal injury in ELBWIs.
在日本，布洛芬（IBU）最近已用于治疗动脉导管未闭（PDA）。我们旨在研究IBU治疗极低出生体重儿（ELBWI）动脉导管未闭的疗效和不良事件，并将其与吲哚美辛（IND）进行比较，重点关注短期肾功能。
对16例ELBWI进行了病例对照研究。符合条件患者的数据分为两组。10例患者在2017年1月至2018年6月期间接受了IND治疗（IND组），而6例在2018年7月至2018年12月期间接受了IBU治疗（IBU组）以治疗PDA。IND组接受0.1mg/kg/12小时的IND静脉输注，共三剂，而IBU组接受10mg/kg的静脉IBU输注，随后2天给予5mg/kg/天。我们比较了两组在PDA闭合疗效和肾功能损害方面的差异。
两组在初次闭合率和所需的PDA结扎方面均未观察到显著差异。两组在脑室内出血和胃肠道并发症的发生率方面均未观察到显著差异。给药后24 - 36小时，IBU组的尿量变化（%）显著高于IND组。出生7天时，IBU组的尿L型脂肪酸结合蛋白浓度水平显著低于IND组。
虽然IBU在PDA闭合率方面与IND相当，但在ELBWI中，IBU在短期肾损伤方面更具优势。
