消炎痛预防动脉导管未闭及其引发支气管肺发育不良的风险:早产儿消炎痛预防性试验的进一步分析

作     者：Schmidt B. Roberts R.S. Fanaroff A. 贺莉 

作者机构：The Departments of Pediatrics and Clinical Epidemiology and Biostatistics McMaster University Hamilton Ont.Canada Dr. 

出 版 物：《世界核心医学期刊文摘（儿科学分册）》 (Dkgest of the World Latest Medical Information)

年 卷 期：2006年第2卷第11期

页      面：29-30页

学科分类：1002[医学-临床医学] 100202[医学-儿科学] 10[医学] 

主　　题：消炎痛 预防性试验 治疗者 极低出生体重儿 预防剂量 安慰剂 预防用药 对数回归 辅助通气 试验设计 

摘      要：Objectives: To determine the risk of bronchopulmonary dysplasia(BPD) in subgroups of infants with and without patent ductus arteriosus (PDA) who were randomized to indomethacin prophylaxis or placebo, and to examine whether adverse drug effects on edema formation and oxygenation may explain why indomethacin prophylaxis does not reduce BPD. Study design:We studied 999 extremely low birth weight infants who participated in the Trial of Indomethacin Prophylaxis in Preterms(TIPP) and who survived to a postmenstrual age of 36 ***: The incidence of BPD in the 2 subgroups of infants with PDA was 52%(55/105) after indomethacin prophylaxis and 56%(137/246) after placebo. In contrast, rates of BPD in the 2 subgroups without a PDA were 43%(170/391) after indomethacin prophylaxis and 30%(78/257) after placebo (P[interaction] = 0.015). Logistic regression analysis with adjustment for prognostic base line factors showed that adverse and independent effects of indomethacin prophylaxis on the need for supplemental oxygen and on weight loss by the end of the first week of life may increase the risk of BPD in infants without PDA. Conclusions: Harmful side effects on oxygenation and edema formation may explain why indomethacin prophylaxis does not prevent BPD even though it reduces PDA.