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目的探讨延长使用布洛芬预防早产儿脑白质损伤的临床疗效和安全性。方法将2008年4月-2009年8月入住本院NICU且符合条件的44例早产儿随机分为3组。对照组15例:服用6剂安慰剂,每次间隔24 h;短程组15例:服用3剂布洛芬和3剂安慰剂,每次间隔24 h;长程组14例:服用6剂布洛芬,每次间隔24 h。分别于矫正胎龄40周、出生3个月、6个月及12个月行新生儿行为神经评定(NBNA)或发育商(DQ)测定;出生4～7 d及出生3个月检查头部MRI。结果 1.NBNA值:矫正胎龄40周时各组NBNA值有明显差异(F=5.80,P<0.01),其中长程组明显高于短程组及对照组(Pa<0.05),短程组与对照组之间差异无统计学意义(P>0.05)。2.DQ值:出生3个月、6个月及12个月时,3组患儿同年龄段比较,DQ值差异均有统计学意义(Pa<0.05),其中长程组明显高于短程组及对照组(Pa<0.05),短程组与对照组之间差异无统计学意义(Pa>0.05)。3.MRI值:3组新生儿期MRI值无统计学差异(P>0.05),但3个月时,3组患儿MRI值差异有统计学意义(P<0.05),其中长程组明显低于对照组(P<0.05)。4.不良反应:长程组用药后出现不良反应4例(28.57%),短程组出现4例(26.67%),对照组出现3例(20.00%),组间比较差异无统计学意义(χ2=0.32,P>0.05)。结论延长使用布洛芬对早产儿脑白质损伤具有明显预防作用,且无特殊不良反应。
Objective To explore the clinical efficacy and safety of prolonging the use of ibuprofen in the prevention of white matter damage in premature infants. Methods Forty-four preterm infants admitted to NICU in our hospital from April 2008 to August 2009 were randomly divided into three groups. Control group of 15 patients: taking 6 placebo, each interval of 24 h; short-term group of 15 patients: taking 3 doses of ibuprofen and 3 placebo, each interval of 24 h; long-term group of 14 patients: taking 6 doses of Bulo Fen, at intervals of 24 h. Neonatal behavioral neurological assessment (NBNA) or developmental quotient (DQ) were measured at corrected gestational age of 40 weeks, at birth of 3 months, 6 months and 12 months; at birth, 4 to 7 days and at birth, MRI. NBNA value: There was significant difference (P <0.05) in NBNA value at 40 weeks after gestation, in which the long-term group was significantly higher than the short-term group and the control group (Pa <0.05) There was no significant difference between groups (P> 0.05). 2.DQ values: DQ values were significantly different between the three groups at the age of 3 months, 6 months and 12 months (P <0.05), among which the long-term group was significantly higher than the short-range group And control group (Pa <0.05). There was no significant difference between short-term group and control group (Pa> 0.05). 3.MRI: There was no significant difference in MRI value between the three groups (P> 0.05), but at 3 months, there was significant difference in MRI between the three groups (P <0.05), and the long-term group was significantly lower In the control group (P <0.05). Adverse reactions: There were 4 adverse reactions (28.57%) in the long-term group, 4 cases (26.67%) in the short-term group and 3 cases (20.00%) in the control group. There was no significant difference between the two groups (χ2 = 0.32, P> 0.05). Conclusion Prolonged use of ibuprofen has a significant preventive effect on white matter damage in preterm infants with no specific adverse reactions.