摘要
目的 探究血小板计数对动脉导管未闭(PDA)极低出生体重儿布洛芬治疗失败的影响,为临床预测PDA治疗结果提供依据。方法 选取2017年5月30日至2020年5月30日在我院出生且接受布洛芬治疗的200例PDA早产儿,患儿胎龄小于37周且体质量小于1500g。布洛芬治疗第一疗程:第1天10mg/kg、第2及3天5mg/kg,第一疗程治疗失败者接受第二疗程治疗,方法同第一疗程。治疗失败定义为两个疗程治疗后动脉导管均未闭合。在第一、二疗程前分别采集患儿外周静脉血检测血常规,观察血小板计数与PDA极低出生体重儿布洛芬治疗失败的相关性,并分析治疗失败的影响因素。结果 200例患儿中,50例两个疗程治疗后均失败。PDA治疗失败患儿胎龄、出生体质量、第二疗程前血小板计数小于治疗成功患儿,动脉导管两端压差、宫内窘迫、窒息史、母亲子痫、合并感染、呼吸支持、新生儿临床危险指数>5分比例、LA/Ao>1.4比例高于治疗成功患儿,出生至布洛芬治疗时间长于治疗成功患儿,差异有统计学意义(P<0.05)。Logistic回归分析显示,合并呼吸窘迫综合征、第二疗程前血小板计数、新生儿临床危险指数评分、动脉导管两端压差、呼吸支持、合并感染是PDA治疗失败的独立影响因素(P<0.05)。第二疗程前血小板计数预测PDA治疗失败的AUC为0.75,特异度为68.4%,灵敏度为74.6%。结论 布洛芬第二疗程前血小板计数降低与PDA治疗失败有关,可用于预测PDA治疗结果。
Objective To investigate the effect of platelet count on the failure of treatment of ibuprofen in very low birth weight infants with patent ductus arteriosus(PDA),and to provide evidence for clinical prediction of PDA treatment results.Methods A total of 200 PDA preterm infants born in our hospital from May 30,2017 to May 30,2020 were treated with ibuprofen.The gestational age was less than 37 weeks and the body weight was less than 1500 g.The first course of treatment with ibuprofen was 10 mg/kg on day 1 and 5 mg/kg on day 2 and 3.Children with treatment failure of the first course received the second course of treatment, which was the same as the first course of treatment.Treatment failure was defined as the absence of closure of the arterial catheter after both courses of treatment.Blood samples were collected from peripheral venous blood samples before the first and second courses of treatment, and the correlation between platelet count and failed treatment of ibuprofen in PDA with very low birth weight was observed, and the influencing factors of treatment failure were analyzed.Results Of the 200 patients, 50 patients failed for two courses of treatment.Gestational age, birth weight, platelet count before treatment in PDA treatment failure children were less than those in successful treatment children, and pressure difference at both ends of the arterial catheter, intrauterine distress, history of asphyxia, maternal eclampsia, co-infection, respiratory support, neonatal clinical risk index>5 ratio, LA/Ao>1.4 ratio in PDA treatment failure children were higher than the successful treatment, the time from birth to ibuprofen was longer than those in successful treatment children, and the time from birth to ibuprofen in PDA treatment failure children was longer than that in successful treatment children(P<0.05).Logistic regression analysis showed that combined respiratory distress syndrome, platelet count before the second course of treatment, neonatal clinical risk index score, arterial catheter pressure differ
作者
刘伟伟
Liu Weiwei(Neihuang County People′s Hospital,Anyang,Henan 456300)
出处
《辽宁医学杂志》
2022年第6期39-42,共4页
Medical Journal of Liaoning
关键词
血小板计数
布洛芬
早产儿
动脉导管未闭
治疗失败
Platelet count
Ibuprofen
Premature infant
Patent ductus arteriosus
Treatment failure
