布洛芬不同给药策略治疗早产儿动脉导管未闭的临床研究  

Clinical Study on Different Administration Strategies of Ibuprofen in the Treatment of Premature Infants with Patent Ductus Arteriosus

作　　者：曾婧婕 侯齐书 叶继锋 唐锦心 Zeng Jinjie;Hou Qishu;Ye Jifeng;Tang Jinxin(Wenzhou Central Hospital,Zhejiang Wenzhou 325000,China;The Second Affiliated Hospital of Wenzhou Medical University,Yuying Children’s Hospital,Zhejiang Wenzhou 325000,China)

机构地区：[1]温州市中心医院,浙江温州325000 [2]温州医科大学附属第二医院、育英儿童医院,浙江温州325000

出　　处：《儿科药学杂志》2025年第2期44-48,共5页Journal of Pediatric Pharmacy

基　　金：2023年温州市基础性科研项目,编号Y2023927。

摘　　要：目的:比较布洛芬不同给药策略治疗早产儿动脉导管未闭(PDA)的有效性和安全性。方法:回顾性收集2022年1月至2024年1月温州市中心医院收治的诊断为有血流动力学意义的PDA(hsPDA)并接受布洛芬治疗的早产儿184例,根据布洛芬不同给药途径、给药剂量、给药时机、给药疗程等进行分组,分析布洛芬不同给药策略PDA关闭率和并发症发生率。结果:布洛芬静脉给药组PDA关闭率与口服给药组比较差异有统计学意义(P<0.05),坏死性小肠结肠炎(NEC)、支气管肺发育不良(BPD)、早产儿视网膜病变(ROP)、颅内出血(IVH)、高胆红素血症、喂养不耐受(FI)等并发症发生率比较差异无统计学意义(P>0.05)。布洛芬静脉给药组少尿、消化道出血发生率高于口服给药组(P<0.05)。口服给药组高剂量亚组和标准剂量亚组PDA关闭率、并发症发生率比较差异无统计学意义(P>0.05)。静脉给药组高剂量亚组PDA关闭率高于标准剂量亚组(P<0.05),BPD、IVH发生率低于标准剂量亚组(P<0.05)。口服给药组和静脉给药组生后>7~14天给药亚组PDA关闭率均高于生后>14天给药亚组(P<0.05),口服给药组生后≤7天给药亚组NEC发生率高于生后>7~14天给药亚组(P<0.05),FI发生率高于生后>14天给药亚组(P<0.05)。静脉给药组生后≤7天给药亚组消化道出血发生率高于生后>7~14天给药亚组(P<0.05)。口服给药组和静脉给药组2个疗程亚组PDA关闭率、ROP发生率高于单疗程亚组(P<0.05)。结论:hsPDA早产儿生后>7~14天静脉给药高剂量布洛芬、单疗程失败后重复第2疗程的治疗策略在提高PDA关闭率的同时又能保证安全性,可作为PDA优化给药策略在临床上推广应用。Objective:To compare the efficacy and safety of different administration strategies of ibuprofen in the treatment of premature infants with patent ductus arteriosus(PDA).Methods:A total of 184 premature infants diagnosed with hemodynamically significant patent ductus arteriosus(hsPDA)and treated with ibuprofen were retrospectively collected from Wenzhou Central Hospital from Jan.2022 to Jan.2024.The closure rate of PDA and complication rate of ibuprofen were analyzed according to different routes of administration,dosage,timing and duration of administration.Results:There was significant difference in closure rate of PDA between ibuprofen intravenous administration group and oral administration group(P<0.05).There were no significant differences in the incidence of necrotizing enterocolitis(NEC),bronchopulmonary dysplasia(BPD),retinopathy of prematurity(ROP),intracranial hemorrhage(IVH),hyperbilirubinemia and feeding intolerance(FI)between ibuprofen intravenous administration group and oral administration group(P>0.05).The incidence of oliguria and gastrointestinal bleeding in the ibuprofen intravenous administration group was significantly higher than that in oral administration group(P<0.05).There were no significant differences in the closure rate of PDA and incidence of complication between the high dose and standard dose subgroup of oral administration group(P>0.05).However,in intravenous administration group,the closure rate of PDA was higher in high dose subgroup than that in standard dose subgroup(P<0.05),and the incidence of BPD and IVH was significantly lower than that in standard dose subgroup(P<0.05).Both in oral and intravenous administration groups,the closure rate of PDA in>7 to 14 d postnatal administration subgroup was higher than that in>14 d postnatal administration subgroup(P<0.05).In oral administration group,the incidence of NEC in≤7 d postnatal administration subgroup was significantly higher than that in>7 to 14 d postnatal administration subgroup(P<0.05),the incidence of FI in≤7 d pos

关 键 词：布洛芬 动脉导管未闭 并发症 早产儿 

分 类 号：R722.6[医药卫生—儿科]