Xiao Yingqi, Liu Hui, Hu Rujun, You Qiang, Zeng Min, Jiang Xiaolian
West China School of Nursing/ West China Hospital, Sichuan University, Chengdu, China.
Key Laboratory of Birth Deficits and Related Diseases of Women and Children, West China Second University Hospital, Sichuan University, Chengdu, China.
Front Pediatr. 2020 Feb 18;7:568. doi: 10.3389/fped.2019.00568. eCollection 2019.
Indomethacin and ibuprofen, two commonly used prostaglandin inhibitors, are the drugs of choice for patent ductus arteriosus. However, paracetamol is an alternative choice when these drugs are ineffective or contraindicated. This study aimed to confirm paracetamol's efficacy and safety compared with those of other drugs or placebos for patent ductus arteriosus closure in premature infants. We conducted a literature search using the Cochrane Library, PubMed, CINAHL, and EMBASE databases for randomized controlled trials and quasi-randomized controlled trials. We used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to direct the process and PICO (P, population; I, intervention/interest; C, comparator; O, outcome) principle to constitute the theme. We combined the research data through qualitative summaries or meta-analyses. The final analyses included 15 trials ( = 1,313). No significant differences were noted between paracetamol and ibuprofen except for shorter mean days needed for patent ductus arteriosus closure, lower risk of gastrointestinal bleeding, and hyperbilirubinemia. No significant difference existed between paracetamol and indomethacin. Oral paracetamol was more effective than placebo in infants weighing 1,501-2,500 g. Our study findings tentatively conclude that paracetamol can induce early patent ductus arteriosus closure without significant side effects but that its efficacy is not superior to that of indomethacin.
吲哚美辛和布洛芬是两种常用的前列腺素抑制剂，是治疗动脉导管未闭的首选药物。然而，当这些药物无效或禁忌时，对乙酰氨基酚是一种替代选择。本研究旨在证实与其他药物或安慰剂相比，对乙酰氨基酚在早产儿动脉导管未闭闭合方面的疗效和安全性。我们使用Cochrane图书馆、PubMed、CINAHL和EMBASE数据库进行文献检索，以查找随机对照试验和半随机对照试验。我们使用系统评价和Meta分析的首选报告项目（PRISMA）指南来指导该过程，并采用PICO（P，人群；I，干预/感兴趣的事物；C，对照；O，结局）原则来构建主题。我们通过定性总结或Meta分析来合并研究数据。最终分析纳入了15项试验（n = 1,313）。除动脉导管未闭闭合所需的平均天数更短、胃肠道出血风险更低以及高胆红素血症外，对乙酰氨基酚和布洛芬之间未观察到显著差异。对乙酰氨基酚和吲哚美辛之间也没有显著差异。口服对乙酰氨基酚在体重1501 - 2500 g的婴儿中比安慰剂更有效。我们的研究结果初步得出结论，对乙酰氨基酚可诱导动脉导管未闭早期闭合且无明显副作用，但其疗效并不优于吲哚美辛。
