Objective To test the feasibility of oral ibuprofen treatment in preterm infants with patent ductus venosus(PDV). Methods A total of 90 neonates hospitalized with neonatal jaundice and diagnosed with PDV by echocardiography within 24 hours after birth were enrolled in this study from March 2016 to July 2017.And participants were randomly divided into the treatment group(n=45) and control group(n=45).The treatment group was orally administered ibuprofen of 10 mg/kg within 24 hours after birth, followed 24 hours later by the second dose of 5 mg/kg and 48 hours later by the third dose of 5 mg/kg.While the control group was treated with placebo(normal saline) of 1 ml/kg, followed 24 hours later by the second dose of 0.5 ml/kg and 48 hours later by the third dose of 0.5ml/kg.The total bilirubin (TB), direct bilirubin (DBIL), indirect bilirubin (IBIL) and serum ammonia levels were tested before and after treatment in two groups.The two groups were examined by echocardiography after treatment, also the efficacy and adverse reactions of the two groups were observed after treatment. Results 1)The rate of closure of ductus venosus in the treatment group was significantly higher than that in the control group (77.8% vs.22.2%, P＜0.01).2)The levels of TB, DBIL, IBIL and blood ammonia after treatment in the treatment group were significantly lower than those in the control group (P＜0.01).3) In terms of adverse reactions,the differences on positive rate of fecal occult blood, the rates of intracranial hemorrhage, necrotizing enterocolitis,oliguria and feeding intolerance between two groups were not significant (all P＞0.05).Also, the levels of platelet and creatinine in two groups were not significantly different (P＞0.05). Conclusion Oral administration of ibuprofen can effectively promote the closure of PDV with clinical application of relative safety.
Key words
ibuprofen /
patent ductus venosus /
infants /
premature
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
References
[1] 吕震宇, 金梅.胎儿静脉导管血流动力学研究[J].心肺血管病杂志,2014,33(3) 3:456-459.
[2] Bernard O,Franchi-AbellaS,Branchereaus, et al.Congenital portosystemic shunts in children:recognition, evaluation, and management[J].Semin Liver Dis,2012,32(4):273-287.
[3] Franchi-Abella S, Branchereau S, Lambert V, et al.Complications of congenital portosystemic shunts in children:therapeutic options and outcomes[J].J Pediatr Gastroenterol Nutr,2010,51(3):332-330.
[4] Ferrero GB, Porta F, Biamino E, et al.Remittent hyperammonemia in congenital portosystemicshunt[J].Eur J Pediatr,2010,169(3):369-372.
[5] Sokollik C, Bandsma RH, Gana JC, et al.Congenital portosystemicshunt:characterization of a multisystem disease[J].J Pediatr Gastroenterol Nutr,2013,56(6):675-681.
[6] Ohlsson A, Walia R, Shah S, et al.Ibuprofen for the treatment of patent ductus arteriosus in preterm and/of low birth weight infants[J].Cochrance Database Syst Rev,2008,23(1):CD003481.
[7] vanOvermeire B, Smets K, Lecoutere D, et al .A comparison of ibuprofenand indomethacin for closure of patent ductusarteriosus[ J].N Engl J Med,2000,343(10):674-681.
[8] Hamrick SEG, Hansmann G, et al.Patent ductusarteriosus of the preterm infant[J].Pediatrics,2010,125(5):1020-1030.
[9] 王卫平.儿科学[M].8版.北京:人民卫生出版社,2013:120.
[10] Clyman RI.Patent dutusarteriosus in the preterm infant[M]//Gleason CA, Devaskar SU.Avery′s Diseases of the Newborn.9th ed.Philadelphia:Elsevier Saunders,2012:751-761.
[11] 黄志勇, 瞿国萍, 罗伟权,等.超声评估新生儿静脉导管闭合时间及Z值分布[J].中国新生儿科杂志,2016,31(2):125-128.
[12] Kim MJ, Ko JS, Seo JK, et al.Clinical features of congenital portosystemic shunt in children[J].Eur J Pediatr,2012,171(2):395-400.
[13] Ripamonti R, Ferral H, Alonzo M, et al.Transjugular intrahepatic portosystemic shunt-related complications and practical solutions[J].Semin Intervent Radiol,2006,23(2):165-176.
[14] 吴碧君, 谢佳佳, 周苏晋,等.彩色多普勒超声诊断肝内门-体静脉分流价值探讨[J].实用肝脏病杂志,2015,18(4):391-394.
[15] Murayama K, Nagasaka H, Tate K, et al.Significant correlation between the flow volume of patent ductusvenosus and early neonatal liver function:possible involvement of patent ductusvenosus in postnatal liver function[J].Arch Dis Child Fetal Neonatal Ed,2006,91(3):175-179.
[16] 杨波, 王军, 高翔羽,等.不同药物治疗早产儿症状性动脉导管未闭对前列腺素E2影响的随机对照研究[J].中国新生儿科杂志,2016,31(1):2-8.
[17] 高翔羽, 黑明燕, 杨波,等.早产儿动脉导管未闭治疗前后血浆前列腺素E2水平变化的研究[J].中华心脏与心律电子杂志,2015,3(2):23-29.
[18] Pacifici GM.Clinical pharmacology of indomethacin in preterm infants:implications in patent ductusarteriousclosure[J].Paediatr Drugs,2013,15(5):363-376.
[19] Walker S, Matheson PJ, Galganski LA, et al.Application of prostaglandin E2 improves ileal blood flow in NEC[J].J Pediatr Surg,2014,49(6):945-949.
PDF(986 KB)
