Patent ductus arteriosus(PDA) is a common clinical condition in preterm infants which is inversely related to birth weight and gestational age. Cyclooxygenase inhibitors such as indomethacin and ibuprofen which block ...Patent ductus arteriosus(PDA) is a common clinical condition in preterm infants which is inversely related to birth weight and gestational age. Cyclooxygenase inhibitors such as indomethacin and ibuprofen which block the prostaglandin conversion from arachidonic acid are the most commonly used drugs for ductal closure. This review focuses on the safety and efficacy oral medications in the management of PDA in preterm infants. Ibuprofen seems to be the first choice due to its higher safety profile, as it is associated with fewer gastrointestinal and renal side effects when compared to indomethacin. PDA closure rates are better with oral than with intravenous ibuprofen probably due to the pharmacokinetic of the drug. However, these medications were reported to be associated with several adverse including transient renal failure, gastrointestinal bleeding and perforation, hyperbilirubinemia and platelet dysfunction. Paracetamol seems be an alternative to PDA therapy with lower adverse events and side effects.展开更多
目的探讨早期补充小剂量左旋甲状腺素钠(LT_4)对早产儿暂时性甲状腺功能低下的临床疗效及安全性。方法选取早产儿148例,其中诊断为早产儿暂时性甲状腺功能低下的患儿64例,应用随机数字表法随机分为治疗组和非治疗组,各32例。非治疗组给...目的探讨早期补充小剂量左旋甲状腺素钠(LT_4)对早产儿暂时性甲状腺功能低下的临床疗效及安全性。方法选取早产儿148例,其中诊断为早产儿暂时性甲状腺功能低下的患儿64例,应用随机数字表法随机分为治疗组和非治疗组,各32例。非治疗组给予基础治疗,治疗组予以早期补充小剂量LT_4治疗,观察并记录所有患者甲状腺激素水平、临床指标及智力量表,同时对比生长发育及并发症状况。结果非治疗组不同时间点游离三碘甲状腺原氨酸(free triiodothyronine,FT_3)、三碘甲状腺原氨酸(triiodothyronine,T_3)、游离甲状腺素(free thyroxine,FT_4)、甲状腺素(thyroxine,T_4)升高,治疗组不同时间点FT_3、T_3、FT_4、T_4、促甲状腺素(thyrotropin,TSH)升高,随着治疗时间延长,与非治疗组比较,治疗组治疗7、14、21 d时FT_3、FT_4较高,治疗14、21 d时T_3、T_4较高,治疗21 d时TSH较高,差异具有统计学意义(P<0.05);治疗组达全胃肠喂养时间、光疗总时间及住院时间较短,新生儿神经行为测定评分法(neonatal behavioral neurological assessment,NBNA)较高,治疗后6个月生长发育状况(身高、体质量、头围生长),治疗后2年中国修订韦氏儿童智力量表(Chinese Wechsler Young Children scale of Intelligence,C-WYCSI)评分更显著,差异具有统计学意义(P<0.05)。结论早期补充小剂量LT4对早产儿暂时性甲状腺功能低下疗效确切,有助促进其神经系统发育。展开更多
文摘Patent ductus arteriosus(PDA) is a common clinical condition in preterm infants which is inversely related to birth weight and gestational age. Cyclooxygenase inhibitors such as indomethacin and ibuprofen which block the prostaglandin conversion from arachidonic acid are the most commonly used drugs for ductal closure. This review focuses on the safety and efficacy oral medications in the management of PDA in preterm infants. Ibuprofen seems to be the first choice due to its higher safety profile, as it is associated with fewer gastrointestinal and renal side effects when compared to indomethacin. PDA closure rates are better with oral than with intravenous ibuprofen probably due to the pharmacokinetic of the drug. However, these medications were reported to be associated with several adverse including transient renal failure, gastrointestinal bleeding and perforation, hyperbilirubinemia and platelet dysfunction. Paracetamol seems be an alternative to PDA therapy with lower adverse events and side effects.
文摘目的探讨早期补充小剂量左旋甲状腺素钠(LT_4)对早产儿暂时性甲状腺功能低下的临床疗效及安全性。方法选取早产儿148例,其中诊断为早产儿暂时性甲状腺功能低下的患儿64例,应用随机数字表法随机分为治疗组和非治疗组,各32例。非治疗组给予基础治疗,治疗组予以早期补充小剂量LT_4治疗,观察并记录所有患者甲状腺激素水平、临床指标及智力量表,同时对比生长发育及并发症状况。结果非治疗组不同时间点游离三碘甲状腺原氨酸(free triiodothyronine,FT_3)、三碘甲状腺原氨酸(triiodothyronine,T_3)、游离甲状腺素(free thyroxine,FT_4)、甲状腺素(thyroxine,T_4)升高,治疗组不同时间点FT_3、T_3、FT_4、T_4、促甲状腺素(thyrotropin,TSH)升高,随着治疗时间延长,与非治疗组比较,治疗组治疗7、14、21 d时FT_3、FT_4较高,治疗14、21 d时T_3、T_4较高,治疗21 d时TSH较高,差异具有统计学意义(P<0.05);治疗组达全胃肠喂养时间、光疗总时间及住院时间较短,新生儿神经行为测定评分法(neonatal behavioral neurological assessment,NBNA)较高,治疗后6个月生长发育状况(身高、体质量、头围生长),治疗后2年中国修订韦氏儿童智力量表(Chinese Wechsler Young Children scale of Intelligence,C-WYCSI)评分更显著,差异具有统计学意义(P<0.05)。结论早期补充小剂量LT4对早产儿暂时性甲状腺功能低下疗效确切,有助促进其神经系统发育。
