布洛芬对新生儿呼吸窘迫综合征诱发动脉导管未闭患者的疗效  

Effect of ibuprofen on neonatal respiratory distress syndrome induced patent ductus areriosus in infants

作　　者：赵进方 ZHAO Jinfang(Department of Pediatrics,Hospital of Maternal and Child Health in Puyang,Puyang 457000,China)

机构地区：[1]濮阳市妇幼保健院儿科,濮阳457000

出　　处：《西北药学杂志》2018年第4期535-538,共4页Northwest Pharmaceutical Journal

摘　　要：目的探讨布洛芬对新生儿呼吸窘迫综合征诱发的动脉导管未闭(PDA)患者心肌损伤的影响。方法选择入院治疗的90例呼吸窘迫综合征诱发PDA的新生儿,在出生后72h取股静脉血测定血清cTnT和CK-MB水平,并进行动脉超声心动图检查,根据检查结果分为PDA组(41例)和对照组(49例)。PDA组患儿接受布洛芬治疗,对照组给予生理盐水。1个疗程(7d)后再次测定患儿血清cTnT和CK-MB,同时进行动脉超声心动图并进行相关分析。结果治疗前,PDA组血清cTnT和CK-MB均高于对照组(P<0.05)。治疗成功的32例PDA组患儿血清cTnT和CK-MB较治疗前显著降低(P<0.05),且与对照组第2次检测水平比较差异无统计学意义;治疗失败的9例PDA组患儿血清cTnT和CK-MB较治疗前稍有降低,差异无统计学意义,但与对照组第2次检测结果相比,二者水平仍明显偏高(P<0.05)。PDA组患儿血清cTnT水平与动脉导管直径呈正相关,CKMB则与性别、胎龄、体质量和分娩方法存在相关性。结论呼吸窘迫综合征诱发的PDA患儿存在一定程度的心肌损伤,经布洛芬治疗,可逆转心肌损伤。临床动态监测cTnT和CK-MB有助于PDA并发心肌损伤的早期诊断和及时干预。Objective To investigate the effect of ibuprofen on neonatal respiratory distress syndrome induced patent ductus areriosus（PDA）in infants.Methods 90 infants with neonatal respiratory distress syndrome induced PDA accepted echocardiography examination,and their blood samples were collected to determine cardiac troponin T（cTnT）and creatine kinase MB isoenzyme（CKMB）levels 72 hafter deliveries.All subjects were divided into 2 group according to the echocardiogram results,PDA group and control group.After ibuprofen treatment,cTnT and CK-MB of the 2 groups were re-measured and the PDA group were taken echocardiography again.Chi-square test,t-test and multi-variate linear regression were performed for statistical analysis.Results Before treatment,cTnT and CK-MB levels of PDA group were significantly higher than those of control group（P0.05）.For 32 successful treatment infants,cTnT and CK-MB levels decreased markedly,compared with those levels before treatment（P0.05）.For the 9 infants failed to close ductus,the cTnT and CK-MB levels were lower than those before treatment,but these had no statistical significance（P0.05）.The levels of cTnT were positively related to the duration of ventilation.The CK-MB level was associated to gender,gestational age,birth weight,and delivery mode.Conclusion There is a certain degree of myocardial injury in infants with respiratory distress syndrome induced PDA.After treatment with ibuprofen,myocardial injury can be reversed.This indicated that clinical dynamic monitoring of cTnT and CK-MB is helpful for early diagnosis and timely intervention of PDA complicated with myocardial injury.

关 键 词：布洛芬 动脉导管未闭 肌钙蛋白T 肌酸激酶MB同工酶 

分 类 号：R985[医药卫生—药品]