A Control Study Of Acetaminophen And Ibuprofen In The Treatment Of Patent Ductus Arteriosus In Preterm Infants Of Different Gestational Ages

Objective To observe the efficacy and safety of oral acetaminophen and ibuprofen in the treatment of patent ductus arteriosus（PDA）in preterm infants and the difference of PDA closure in premature infants of different gestational ages.Methods A total of 110 premature infants with PDA（gestational age<37 weeks）admitted to the Department of Neonatology of our hospital from January 2016 to January 2020 were selected to retrospective analysis.According to the 5^thedition of practical neonatology,the preterm infants were divided into three groups according to gestational age:28～31⁺⁶weeks group（42cases）,32～33⁺⁶weeks group（28cases）,and 34～36⁺⁶weeks group（40 cases）,to compare the difference in PDA closure of premature infants with different gestational ages in the 3 groups.According to different oral drugs,each group is divided into acetaminophen group and ibuprofen group:28～31⁺⁶weeks,paracetamol group 22 cases,ibuprofen group 20 cases,32～33⁺⁶weeks,paracetamol group 13 cases,15 cases in the ibuprofen group,34～36⁺⁶weeks,paracetamol group 19 cases and 21 cases in the ibuprofen group.To observe the efficacy and safety of oral acetaminophen and ibuprofen in the treatment of patent ductus arteriosus（PDA）in premature infants of different gestational age.Results The closing rate of PDA in 28～31⁺⁶weeks group,the acetaminophen group was 72.7%（16/22）,and the ibuprofen group was 60.0%（12/20）.The closing rate of PDA in 32～33⁺⁶weeks,the acetaminophen group was 84.6%（11/13）,the ibuprofen group was 86.7%（13/15）.The closing rate of PDA in 34～36⁺⁶weeks,the paracetamol group was 84.2%（16/19）,and the ibuprofen group was 90.5%（19/21）.There was no statistically significant difference in the PDA closure rate of premature infants with different gestational ages(28～31⁺⁶weeks group,32～33⁺⁶weeks group,34～36⁺⁶weeks group)between oral ibuprofen and acetaminophen（all P>0.05）.The PDA closure rates of the 28～31⁺⁶week group,32～33⁺⁶week group,and 34～36⁺⁶week group were 66.7%,85.7%,and 87.5%respectively,and the difference was statistically significant（?2=6.374,P=0.041）.There were no significant differences in the incidence of upper gastrointestinal hemorrhage,intraventricular hemorrhage（IVH）,necrotizing enterocolitis（NEC）,retinopathy of prematurity（ROP）,bronchopulmonary dysplasia（BPD）,decreased urine output and hyperbilirubinemia between the acetaminophen group and the ibuprofen group（all P>0.05）.Conclusions There was no statistical difference between acetaminophen and ibuprofen in the treatment of PDA in premature infants with different gestational ages.There was no significant difference in the incidence of adverse reactions between the two drugs.PDA closure rates in preterm infants with different gestational ages were different,the smaller the gestational age was,the lower the closure rate was.