布洛芬与对乙酰氨基酚治疗早产儿症状性动脉导管未闭对患儿血浆和尿前列腺素E2水平的影响

摘要

目的 分析布洛芬与对乙酰氨基酚治疗早产儿症状性动脉导管未闭(sPDA)对患儿血浆和尿前列腺素E2(PGE2)水平的影响.方法 纳入2014年7月至2016年12月我院出生的患有sPDA的84例早产儿作为观察对象.随机纳入42例给予布洛芬进行治疗(A组),另外42例给予对乙酰氨基酚治疗(B组).对比两组治疗疗效,治疗前后血浆和尿PGE2水平以及不良反应.结果 两组患儿在各时段的关闭率以及总关闭率的组间差异均无统计学意义(P>0.05).经治疗,两组患儿血浆PGE2和尿PGE2水平均较治疗前下降,与治疗前比较差异有统计学意义(P<0.05);A组下降程度稍大于B组,但组间差异均无统计学意义(P>0.05).经治疗,两组患儿肝肾功能指标血肌酐(SCr)和丙氨酸氨基转移酶(ALT)水平均较治疗前略有上升(P>0.05),血小板(PLT)较治疗前有所下降,但差异无统计学意义(P>0.05);两组SCr、ALT及PLT水平比较差异无统计学意义(P>0.05).B组高胆红素血症比例低于A组,组间差异有统计学意义(P<0.05),其他不良反应上,组间差异均无统计学意义(P>0.05).结论 布洛芬与对乙酰氨基酚的疗效相当,其对血浆PGE2和尿PGE2水平的影响略强于对乙酰氨基酚,但对乙酰氨基酚高胆红素血症的比例低于布洛芬.%Objective To observe the effect of ibuprofen and paracetamol on plasma and urinary prostaglandin E2(PGE2) levels in the treatment of premature infants with symptomatic patent ductus arteriosus(sPDA).Methods Totally 84 premature infants with sPDA from July 2014 to December 2016 were included.In which,42 patients were treated with ibuprofen (group A)and 42 patients were treated with paracetamol (group B).Effects,plasma and urinary PGE2 level and adverse reaction were compared between the two groups.Results There was no significant difference in sPDA closure rate during each period and total closure rate between the two groups (P>0.05).After treatment,the plasma and urinary PGE2 levels decreased (P<0.05),but no significant difference was found between the two groups (P>0.05).After treatment,the serum creatinine (SCr) and alanine aminotransferase (ALT) increased slightly,while platelet (PLT) level decreased slightly,however,there was no significant difference before and after treatment (P>0.05).There was no significant difference in the levels of SCr and ALT between the two groups (P>0.05).The proportion of hyperbilirubinemia in group B was lower than that of group A (P<0.05),but there was no significant difference between the two groups in other adverse reactions (P>0.05).Conclusion The efficacy of ibuprofen and paracetamol is equivalent.The influence of ibuprofen on plasma and urinary PGE2 levels is more than paracetamol,the hyperbilirubinemia ratio is lower.