动脉导管未闭早产儿血前列腺素E代谢物水平的评估：一项前瞻性研究

Assessment of Blood Prostaglandin E Metabolite Levels among Infants Born Preterm with Patent Ductus Arteriosus: A Prospective Study.

作者信息

Nagafuji Motomichi, Fujiyama Satoshi, Doki Kosuke, Ishii Ryota, Okada Yuki, Hanaki Mai, Nakamura Yuri, Takeuchi Shusuke, Hitaka Daisuke, Kanai Yu, Saito Makoto, Miyazono Yayoi, Homma Masato, Takada Hidetoshi

机构信息

Department of Pediatrics, University of Tsukuba Hospital, Tsukuba Ibaraki, Japan.

Department of Pediatrics, University of Tsukuba Hospital, Tsukuba Ibaraki, Japan; Department of Child Health, Institute of Medicine, University of Tsukuba, Tsukuba Ibaraki, Japan; Department of Pediatrics, Ibaraki Prefectural Central Hospital, Kasama Ibaraki, Japan.

出版信息

J Pediatr. 2025 Jan;276:114285. doi: 10.1016/j.jpeds.2024.114285. Epub 2024 Sep 2.

DOI:10.1016/j.jpeds.2024.114285

PMID:39233116

Abstract

OBJECTIVE

To assess the role of prostaglandin E by measuring blood prostaglandin E metabolite (PGEM) concentrations in preterm infants with patent ductus arteriosus (PDA).

STUDY DESIGN

A prospective observational study of preterm infants born before 32 weeks of gestational age (GA) was performed in a single tertiary hospital in Japan. Blood samples were collected to measure serum concentrations of PGEM, ibuprofen (IBU), and cytokines. Multiple regression analyses assessed associations between blood PGEM levels and perinatal factors, development of hemodynamically significant PDA (hsPDA), and IBU treatment response of hsPDA.

RESULTS

Seventy-nine infants (median GA 28 weeks) were enrolled in this study. Forty-seven received IBU for hsPDA treatment 1 d after birth in median. PDA closure occurred in 25 infants after a single IBU treatment. Serum PGEM concentrations were associated with histologic chorioamnionitis (P < .01), but not with GA, respiratory distress syndrome, or serum IL-6 concentrations. Serum PGEM concentrations decreased after initial IBU treatment; however, they were not associated with hsPDA development (P = .39). IBU concentrations correlated with IBU treatment response (aOR 1.29, P < .01). However, pre-IBU serum PGEM levels and PGEM reduction ratio did not (P = .13, .15, respectively).

CONCLUSIONS

Serum PGEM concentrations in preterm infants were associated with maternal histologic chorioamnionitis, but not hsPDA development. IBU treatment response was associated with higher blood IBU concentrations, but not PGEM concentrations.

摘要

目的

通过测量动脉导管未闭（PDA）早产儿的血液前列腺素E代谢物（PGEM）浓度，评估前列腺素E的作用。

研究设计

在日本一家三级医院对孕周小于32周（GA）的早产儿进行了一项前瞻性观察研究。采集血样以测量PGEM、布洛芬（IBU）和细胞因子的血清浓度。多元回归分析评估血液PGEM水平与围产期因素、血流动力学显著的PDA（hsPDA）的发生以及hsPDA的IBU治疗反应之间的关联。

结果

本研究纳入了79例婴儿（GA中位数为28周）。47例婴儿在出生后1天中位数时接受了IBU治疗hsPDA。单次IBU治疗后，25例婴儿的PDA闭合。血清PGEM浓度与组织学绒毛膜羊膜炎相关（P <.01），但与GA、呼吸窘迫综合征或血清IL-6浓度无关。初始IBU治疗后血清PGEM浓度降低；然而，它们与hsPDA的发生无关（P = 0.39）。IBU浓度与IBU治疗反应相关（调整后比值比1.29，P <.01）。然而，IBU治疗前血清PGEM水平和PGEM降低率与之无关（分别为P = 0.13、0.15）。