对早产儿尽早给予吲哚美辛。
Early administration of indomethacin to preterm infants.
作者信息
Rennie J M, Doyle J, Cooke R W
出版信息
Arch Dis Child. 1986 Mar;61(3):233-8. doi: 10.1136/adc.61.3.233.
Abstract
Indomethacin (0.2 mg/kg) or saline was given intravenously during the first 24 hours to 50 preterm infants in a double blind controlled trial. Eight of the control group later required treatment with indomethacin for clinical signs of left to right shunt, but only one in the treatment group (p = 0.03). Treatment with indomethacin prolonged bleeding time, raised serum creatinine concentrations, and was associated with gastrointestinal haemorrhage in seven infants. Five of these had a serum indomethacin concentration greater than 1.0 microgram/ml. There was a significant reduction of the stable metabolite of prostacyclin, 6-ketoprostaglandin F1 alpha, commencing six hours after treatment and lasting for four days. There was no significant difference in the incidence of intraventricular haemorrhage, days of treatment with oxygen or ventilation, or mortality between the two groups.
摘要
在一项双盲对照试验中，在最初24小时内给50名早产儿静脉注射吲哚美辛（0.2毫克/千克）或生理盐水。对照组中有8名后来因左向右分流的临床症状需要用吲哚美辛治疗，但治疗组中只有1名（p = 0.03）。吲哚美辛治疗延长了出血时间，提高了血清肌酐浓度，并与7名婴儿的胃肠道出血有关。其中5名婴儿的血清吲哚美辛浓度大于1.0微克/毫升。从治疗后6小时开始并持续4天，前列环素的稳定代谢产物6-酮前列腺素F1α显著减少。两组之间在脑室内出血发生率、吸氧或通气治疗天数或死亡率方面没有显著差异。
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本文引用的文献
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Pharmacokinetics of indomethacin in the neonate. Relation of plasma indomethacin levels to response of the ductus arteriosus.吲哚美辛在新生儿中的药代动力学。血浆吲哚美辛水平与动脉导管反应的关系。
N Engl J Med. 1981 Jul 9;305(2):67-72. doi: 10.1056/NEJM198107093050203.
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Prophylactic indomethacin therapy for patent ductus arteriosus in very-low-birth-weight infants.极低出生体重儿动脉导管未闭的预防性吲哚美辛治疗
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Prostaglandins, renal function and vascular regulation.前列腺素、肾功能与血管调节
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