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目的对比观察口服布洛芬与吲哚美辛对早产儿动脉导管未闭(PDA)的疗效及安全性。方法将近3a收治的36例PDA早产儿作为布洛芬组。于出生2～7d分3次予口服布洛芬治疗,首剂给予10mg/kg,于24h、48h后再分别给予5mg/kg。将2003年6月-2005年12月采用吲哚美辛治疗的33例PDA早产儿作为吲哚美辛组。服药首剂0.2mg/kg,间隔12h1次,共3次。观察二组疗效和不良反应。结果布洛芬组PDA关闭29例(80.56%),吲哚美辛组关闭27例(81.82%),二组比较差异无统计学意义(χ2=0.02P>0.05)。布洛芬组5d前与5d后用药关闭率分别为91.30%、61.54%(21/23例、8/13例),二者比较差异有统计学意义(χ2=4.70P<0.05);吲哚美辛组5d前及5d后用药关闭率分别为95.0%、61.54%(19/20例、8/13例),二者比较差异有统计学意义(χ2=5.93P<0.05)。布洛芬组与吲哚美辛组比较5d前与5d后用药关闭率均无统计学差异。布洛芬组发生不良反应6例(16.67%),吲哚美辛组发生不良反应16例(48.48%),二组比较差异有统计学意义(χ2=8.03P<0.01)。结论口服布洛芬治疗早产儿PDA疗效与吲哚美辛相当,但前者不良反应少,安全系数高。
Objective To compare the efficacy and safety of oral ibuprofen and indomethacin on patent ductus arteriosus (PDA) in preterm infants. Methods 36 cases of premature infants with PDA were treated as ibuprofen group in recent 3 years. Oral administration of ibuprofen was given 3 times at 2 ~ 7 days after birth. The first dose was given at 10 mg / kg and then at 5 mg / kg at 24h and 48h. 33 cases of premature infants with PDA treated with indomethacin from June 2003 to December 2005 were treated as indometacin group. The first dose of medication 0.2mg / kg, interval 12h1 times, a total of 3 times. Two groups were observed efficacy and adverse reactions. Results In the ibuprofen group, 29 cases (80.56%) had PDA closure and 27 cases (81.82%) had indomethacin closure. There was no significant difference between the two groups (χ2 = 0.02P> 0.05). The closing rates of drugs in the ibuprofen group before and after 5 days were 91.30% and 61.54% (21/23, 8/13) respectively, with significant difference between the two groups (χ2 = 4.70P <0.05) The closure rates of Metin group before and after 5 days were 95.0% and 61.54% (19/20, 8/13), respectively. The difference between the two groups was statistically significant (χ2 = 5.93P <0.05). There was no significant difference between the ibuprofen group and indomethacin group before 5 days and 5 days after treatment. There were 6 adverse reactions (16.67%) in the ibuprofen group and 16 (48.48%) adverse reactions in the indomethacin group. There was significant difference between the two groups (χ2 = 8.03P <0.01). Conclusions Oral ibuprofen is effective in treating PDA in preterm infants with indometacin, but the former has less adverse reactions and higher safety factor.