口服对乙酰氨基酚治疗早产儿动脉导管未闭的效果及安全性

Effect and safety of oral paracetamol in premature infants with patent ductus arteriosus

目的:探讨口服对乙酰氨基酚治疗早产儿动脉导管未闭(patent ductus arteriosus,PDA)的效果及安全性。方法:采用前瞻性对照研究方法观察PDA早产儿治疗临床资料,72例经心脏彩超诊断有临床表现的PDA的早产儿分为口服对乙酰氨基酚治疗组(18例)和口服布洛芬对照组(54例),观察两组PDA关闭率、副作用及并发症。结果:治疗组和对照组总关闭率分别为66.7%(12例)和70.4%(38例),差异无统计学意义(χ2=0.087,P=0.768)。除但治疗组高胆红素血症发生率低于对照组外(P<0.05),两组患儿在少尿、NEC、肾功能异常、IVH3-4级发生率寄消化道出血等药物副作用方面的差异均无统计学意义(P>0.05)。结论:对乙酰氨基酚在治疗PDA方面的疗效与布洛芬接近,且高胆红素血症发生率低,适合于在临床推广应用。

Objective To investigate the clinical effect and safety of paracetamol in premature infants with patent ductus arteriosus （PDA）. Method A protrospective comparsion study was performed onthe data of premature infants with PDA. Seventy-two premature infants with echocardiographically comfirmed PDA were randomized into the oral paracetamol group（nl = 18） and the ibuprofen group（n2 = 54）, and the rate of ductal closure, side effects and complications were compared between the two groups. Results The ductus was 66.7% （12 infants） in the paracetamol group, which was similar to 70.4% （38 cases） in the ibuprofen group, with no significant difference （~2 = 0.087,P = 0.768）.Except for the incidence of hyperbilirubinemia in the paracetamol group was higher than that in the ibuprofen group （P 〈 0.05）, no statistical differences were found in the other index （P 〉 0.05）, including oliguria, NEC,renal impairment, the incidence of IVH3-4 and gastrointestinal bleeding. Conclusions The clinical effect of paracetamol in premature infants with PDA is similar to that of ibuprofen, withlower incidence of hyperbilirubinemia, and paraeetamol is worthy of amplication in clinical practice.