延长使用布洛芬预防早产儿脑白质损伤的疗效和安全性  

Effect and Safety of Prolonged Ibuprofen Exposure on Preventing White-Matter Injury in Premature Infants

作　　者：刘汉楚[1] 邵剑波[1] 曾凌空[1] 何正慧[1] 方成志[1] 熊萍[1] 黄砚屏[1] 王巧玲[1] 吴春英[1] 

机构地区：[1]武汉市儿童医院新生儿科,武汉430016

出　　处：《实用儿科临床杂志》2012年第14期1119-1121,共3页Journal of Applied Clinical Pediatrics

摘　　要：目的探讨延长使用布洛芬预防早产儿脑白质损伤的临床疗效和安全性。方法将2008年4月-2009年8月入住本院NICU且符合条件的44例早产儿随机分为3组。对照组15例:服用6剂安慰剂,每次间隔24 h;短程组15例:服用3剂布洛芬和3剂安慰剂,每次间隔24 h;长程组14例:服用6剂布洛芬,每次间隔24 h。分别于矫正胎龄40周、出生3个月、6个月及12个月行新生儿行为神经评定(NBNA)或发育商(DQ)测定;出生4～7 d及出生3个月检查头部MRI。结果 1.NBNA值:矫正胎龄40周时各组NBNA值有明显差异(F=5.80,P<0.01),其中长程组明显高于短程组及对照组(Pa<0.05),短程组与对照组之间差异无统计学意义(P>0.05)。2.DQ值:出生3个月、6个月及12个月时,3组患儿同年龄段比较,DQ值差异均有统计学意义(Pa<0.05),其中长程组明显高于短程组及对照组(Pa<0.05),短程组与对照组之间差异无统计学意义(Pa>0.05)。3.MRI值:3组新生儿期MRI值无统计学差异(P>0.05),但3个月时,3组患儿MRI值差异有统计学意义(P<0.05),其中长程组明显低于对照组(P<0.05)。4.不良反应:长程组用药后出现不良反应4例(28.57%),短程组出现4例(26.67%),对照组出现3例(20.00%),组间比较差异无统计学意义(χ2=0.32,P>0.05)。结论延长使用布洛芬对早产儿脑白质损伤具有明显预防作用,且无特殊不良反应。Objective To explore the clinical efficacy and safety of prolonged ibuprofen exposure on preventing white - matter injury in premature infants. Methods Forty - four cases of premature infants in the NICU of Wuhan Children＇s Hospital from Apr. 2008 to Aug. 2009 were randomly divided into 3 groups. In control group, 15 cases of premature infants received 6 doses of oral placebo at 24 - hour intervals. In short - course treatment group, 15 cases of premature infants received 3 doses of oral ibuprofen suspension at 24 - hour intervals, then followed by 3 doses of placebo postnatal 2 to 3 days. In long - course treatment group, 14 cases of premature infants received 6 doses of oral ibuprofen suspension at 24 -hour intervals. The patients in all 3 groups were measured by the neonatal behavioral neurologico3 assessment （NBNA） at 40 - week correction gestational age and by the development quotient （DQ） at 3,6,12 months old. All of the patiems were detected by mag- netic resonance imaging（MRI） postnatal 4 to 7 days or 3 months old. Results 1. The score of NBNA ：There was significant difference among 3 groups at 40 -week correction gestational age（ F = 5.80, P 〈 0. 01 ）. By paired comparison, the score in long -course treatment group was significantly higher than that in control group and short -course treatment group（ Pa〈 0.05 ）, but there was no significant difference between control group and short - course treatment group（ P 〉 0. 05 ）. 2. The score of DQ ：Compared among 3 groups,there were significant differences at 3,6,12 months old respectively（ P 〈 0.05 ）. The score in long - course treatment group was significantly higher than that in control group and short - course treatment group （ Pa 〈 0.05 ）, but there was no significant difference between control group and short - course treatment group（ Pa 〉 0.05 ）. 3. The score of MR1 ： Among 3 groups no statistical difference was found in the neonatal period （ P 〉 0.05 ）, but there was significant difference at

关 键 词：布洛芬 预防 脑白质损伤 婴儿 早产 

分 类 号：R722.6[医药卫生—儿科]