Mahony L, Carnero V, Brett C, Heymann M A, Clyman R I
N Engl J Med. 1982 Mar 4;306(9):506-10. doi: 10.1056/NEJM198203043060903.
We performed a double-blind, controlled study of prophylactic indomethacin therapy in 47 premature infants (less than 1700 g) who had subclinical patent ductus arteriosus. They received either indomethacin or placebo at a mean age of 2.9 days. Among the 25 infants weighing more than 1000 g, a hemodynamically important ductus shunt developed in only four of the 14 given placebo. The incidence of important shunts, the number of surgical ligations, and the duration of oxygen therapy were not appreciably different between the study groups. In contrast, among the 22 infants who weighed 1000 g or less, a major ductus shunt developed in 10 of the 12 given placebo. In the smaller infants indomethacin therapy was associated with a significantly lower incidence of major shunts, fewer surgical ligations, a decreased duration of oxygen therapy, and fewer days necessary to regain birth weight. We conclude that prophylactic indomethacin therapy in infants weighing under 1000 g prevents the later development of large ductus shunts and decreases morbidity.
我们对47例患有亚临床动脉导管未闭的早产儿（体重小于1700克）进行了一项关于预防性吲哚美辛治疗的双盲对照研究。他们在平均2.9日龄时接受吲哚美辛或安慰剂治疗。在25例体重超过1000克的婴儿中，接受安慰剂治疗的14例中只有4例出现了具有血流动力学意义的动脉导管分流。研究组之间，重要分流的发生率、手术结扎的数量以及氧疗的持续时间没有明显差异。相比之下，在22例体重1000克或以下的婴儿中，接受安慰剂治疗的12例中有10例出现了主要动脉导管分流。在较小的婴儿中，吲哚美辛治疗与主要分流的发生率显著降低、手术结扎减少、氧疗持续时间缩短以及恢复出生体重所需天数减少有关。我们得出结论，对体重低于1000克的婴儿进行预防性吲哚美辛治疗可预防后期大型动脉导管分流的发生并降低发病率。
