极低出生体重儿动脉导管对乙酰氨基酚或吲哚美辛的反应。
Response of the ductus arteriosus to acetaminophen or indomethacin in extremely low birth weight infants.
作者信息
Sutton Courtney C, Slaughter James C, Alrifai Mhd Wael, Hale Jennifer, Reese Jeff
机构信息
Department of Pharmacy, Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, TN, 37232, USA.
Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA.
出版信息
J Perinatol. 2025 Mar;45(3):319-325. doi: 10.1038/s41372-024-02199-5. Epub 2024 Dec 18.
OBJECTIVE
Acetaminophen and indomethacin are used for medical management of a patent ductus arteriosus. This study compared the efficacy of these agents in ELBW infants.
STUDY DESIGN
This was a retrospective study of all courses of indomethacin and acetaminophen. Baseline characteristics, details of pharmacologic therapy, toxicity, and acetaminophen serum concentrations were collected. The primary analysis compared rates of ductus closure with indomethacin versus acetaminophen using Pearson's Chi-squared test.
RESULTS
Ductus closure after a single course of therapy was similar between acetaminophen and indomethacin 16% vs. 18%, (p = 0.79). No differences were found in gestational age, birth weight, patient acuity, toxicity, or acetaminophen concentrations between those courses that resulted in closure compared to those that did not. When comparing single-agent exposure, indomethacin was initiated earlier (9.0 vs. 13.5 days, p = 0.022) but PDA closure rates were similar between groups.
CONCLUSION
Acetaminophen and indomethacin produced similar rates of ductus closure in this population.
目的
对乙酰氨基酚和吲哚美辛用于动脉导管未闭的药物治疗。本研究比较了这些药物在超低出生体重儿中的疗效。
研究设计
这是一项对所有吲哚美辛和对乙酰氨基酚治疗疗程的回顾性研究。收集了基线特征、药物治疗细节、毒性以及对乙酰氨基酚血清浓度。主要分析使用Pearson卡方检验比较了吲哚美辛与对乙酰氨基酚的动脉导管闭合率。
结果
对乙酰氨基酚和吲哚美辛单疗程治疗后的动脉导管闭合情况相似，分别为16%和18%，（p = 0.79）。在导致动脉导管闭合的疗程与未导致闭合的疗程之间，胎龄、出生体重、病情严重程度、毒性或对乙酰氨基酚浓度均未发现差异。比较单药治疗时，吲哚美辛开始用药时间更早（9.0天对13.5天，p = 0.022），但两组之间动脉导管未闭闭合率相似。
结论
在该人群中，对乙酰氨基酚和吲哚美辛的动脉导管闭合率相似。
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