中国当代儿科杂志2024，Vol.26Issue(4)：343-349,7.DOI:10.7499/j.issn.1008-8830.2310145
有血流动力学意义的动脉导管未闭早产儿布洛芬治疗失败的危险因素分析
Risk factors for the failure of ibuprofen treatment in preterm infants with hemodynamically significant patent ductus arteriosus
摘要
Abstract
Objective To investigate the risk factors for the failure of ibuprofen treatment in preterm infants with hemodynamically significant patent ductus arteriosus(hsPDA).Methods A retrospective collection of clinical data was conducted on preterm infants with a gestational age of＜34 weeks who were diagnosed with hsPDA and treated at the Department of Neonatology,Maternal and Child Health Hospital of Hubei Province,Tongji Medical College,Huazhong University of Science and Technology,from January 2018 to June 2023.The subjects were divided into two groups based on the treatment approach:the ibuprofen group(95 cases)and the ibuprofen plus surgery group(44 cases).The risk factors for the failure of ibuprofen treatment in preterm infants with hsPDA were identified by binary logistic regression analysis.Results The binary logistic regression analysis revealed that an increased diameter of the ductus arteriosus,a resistance index(RI)value of the middle cerebral artery ≥0.80,and prolonged total invasive mechanical ventilation time were risk factors for the failure of ibuprofen treatment in preterm infants with hsPDA(P＜0.05).Receiver operating characteristic curve analysis showed that a ductus arteriosus diameter＞2.85 mm,a middle cerebral artery RI value ≥0.80,and a total invasive mechanical ventilation time＞16 days had significant predictive value for the failure of ibuprofen treatment in preterm infants with hsPDA(P＜0.05).The combined predictive value of these three factors was the highest,with an area under the curve of 0.843,a sensitivity of 86.5％,and a specificity of 75.0％(P＜0.05).Conclusions A ductus arteriosus diameter＞2.85 mm,a middle cerebral artery RI value ≥0.80,and a total invasive mechanical ventilation time＞16 days are risk factors for the failure of ibuprofen treatment in preterm infants with hsPDA,and they are of significant predictive value for the necessity of surgical treatment following the failure of ibuprofen treatment.[Chinese Journal of Contemporary Pediatrics,2024,26(4):343-349]关键词
动脉导管未闭/布洛芬治疗/动脉导管未闭手术结扎/高危因素/早产儿Key words
Patent ductus arteriosus/Ibuprofen treatment/Surgical ligation of the ductus arteriosus/Risk factor/Preterm infant引用本文复制引用
吴梓琪,张漪,周茜茜,刘沁,程实,夏世文..有血流动力学意义的动脉导管未闭早产儿布洛芬治疗失败的危险因素分析[J].中国当代儿科杂志,2024,26(4):343-349,7.基金项目
中国疾控中心妇幼中心母婴营养与健康研究项目(2022FYH002). （2022FYH002）
