Kramer H H, Sommer M, Rammos S, Krogmann O
Department of Paediatric Cardiology, Children's Hospital, Heinrich-Heine-University, Düsseldorf, Germany.
Eur J Pediatr. 1995 Sep;154(9):700-7. doi: 10.1007/BF02276712.
This study reports our experience with low-dose prostaglandin E1 (PGE1) treatment of 91 newborns with ductus dependent congenital heart disease (CHD). PGE1 efficacy, side-effects as well as the cardiovascular and respiratory profile of the patients were analysed. PGE1 doses > 0.02 microgram/kg per minute were used for only 5.3% of the total 23,656 h of treatment. The mean systolic blood pressures did not differ from the normal mean for patients with cyanotic CHD, while the diastolic values were lowered. Respiratory support was required only during 13.7% of the total treatment time. Apnoeas occurred in 21 (38%) of the 55 spontaneously breathing infants, who all had a cyanotic CHD. The incidence of apnoeas was lower during treatment with doses < 0.01 microgram/kg per minute.
PGE1 can be successfully administered in lower doses than previously recommended. Especially high initial doses can be avoided and low maintenance doses allow long-term treatment without serious complications.
本研究报告了我们使用低剂量前列腺素E1（PGE1）治疗91例患有动脉导管依赖性先天性心脏病（CHD）新生儿的经验。分析了PGE1的疗效、副作用以及患者的心血管和呼吸状况。在总共23656小时的治疗中，仅5.3%的时间使用了每分钟>0.02微克/千克的PGE1剂量。对于患有青紫型CHD的患者，其平均收缩压与正常平均值无差异，而舒张压降低。仅在总治疗时间的13.7%期间需要呼吸支持。55例自主呼吸的婴儿中有21例（38%）发生呼吸暂停，这些婴儿均患有青紫型CHD。在使用每分钟<0.01微克/千克剂量治疗期间，呼吸暂停的发生率较低。
PGE1可以以低于先前推荐的剂量成功给药。尤其可以避免高初始剂量，低维持剂量允许长期治疗而无严重并发症。
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