目的 探討布洛芬混懸液聯(lián)合醋酸氫化可的松片治療早產(chǎn)兒動脈導管未閉的臨床療效。方法 選取2013年8月-2016年8月天津市薊州區(qū)人民醫(yī)院兒科收治的動脈導管未閉早產(chǎn)兒134例作為研究對象，依據(jù)患者治療方式不同分為布洛芬組（44例）、氫化可的松組（44例）和聯(lián)合組（46例）。布洛芬組口服布洛芬混懸液，首次劑量10 mg/kg，第2、3劑量5 mg/kg，每次間隔24 h，共3次。氫化可的松組口服醋酸氫化可的松片，1片/次，1次/d，治療3 d。聯(lián)合組給予布洛芬混懸液和醋酸氫化可的松片治療，方法同上。觀察3組的臨床療效，比較3組的前列腺素E₂（PGE₂）、N末端B型腦鈉肽（NT-proBNP）、內(nèi)皮素-1（EF-1）和心功能指標。結(jié)果 治療后，布洛芬組、氫化可的松組和聯(lián)合治療組動脈導管未閉關閉率分別為84.09%、79.55%、93.48%，聯(lián)合治療組動脈導管未閉關閉率高于布洛芬組和氫化可的松組，3組比較差異有統(tǒng)計學意義（P<0.05）。治療后，3組血漿PGE₂、尿PGE₂、NT-proBNP和EF-1水平均明顯下降，同組治療前后比較差異具有統(tǒng)計學意義（P<0.05）；且聯(lián)合組這些觀察指標明顯低于布洛芬組和氫化可的松組，差異具有統(tǒng)計學意義（P<0.05）。治療后，3組左心室收縮末前后徑（LVESD）、左心室舒張末前后徑（LVEDD）、左心室收縮末容量（LVESV）和左心室舒張末容量（LVEDV）均明顯下降，同組治療前后比較差異有統(tǒng)計學意義（P<0.05）；且聯(lián)合組這些觀察指標明顯低于布洛芬組和氫化可的松組，差異具有統(tǒng)計學意義（P<0.05）。聯(lián)合組高膽紅素血癥、消化道出血發(fā)生率均低于布洛芬組和氫化可的松組，3組比較差異具有統(tǒng)計學意義（P<0.05）。結(jié)論 布洛芬混懸液聯(lián)合醋酸氫化可的松片治療早產(chǎn)兒動脈導管未閉具有較好的臨床療效，降低了患兒PGE₂、NT-proBNP、EF-1水平，改善患兒心功能指標，安全性較好，具有一定的臨床推廣應用價值。

Objective To investigate the clinical effect of Ibuprofen Suspension combined with Hydrocortisone Acetate Tablets in treatment of patent ductus arteriosus in preterm infants. Methods Premature infants with patent ductus arteriosus in Department of Neonatology of Jizhou District People's Hospital of Tianjin from August 2013 to August 2016 were enrolled in this study. According to the difference treatment plan, children were randomly divided into ibuprofen group (44 cases), hydrocortisone group (44 cases), and combined treatment group (46 cases). Children in the ibuprofen group were po administered with Ibuprofen Suspension, the first dose 10 mg/kg, the second and third dose 5 mg/kg, time interval of 24 h, total 3 times. Children in the hydrocortisone group were po administered with Hydrocortisone Acetate Tablets, 1 tablet/time, once daily, treated for 3 d. Children in the combined treatment group were given Ibuprofen Suspension and Hydrocortisone Acetate Tablets. After treatment, the clinical efficacies were evaluated, and PGE₂, NT-proBNP, EF-1, and cardiac function indexes in three groups were compared. Results After treatment, the patent ductus arteriosus closure rates in the ibuprofen, hydrocortisone, and combined treatment groups were 84.09%, 79.55%, and 93.48%, respectively, and the patent ductus arteriosus closure rates in the combined treatment group was higher than those in the ibuprofen and hydrocortisone groups, and there was difference among three groups (P<0.05). After treatment, the levels of plasma PGE₂, urine PGE₂, NT-proBNP, and EF-1 in three groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the observational indexes in the combined treatment group were significantly lower than those in the ibuprofen and hydrocortisone groups, with significant difference between two groups (P<0.05). After treatment, LVESD, LVEDD, LVESV, and LVEDV in three groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the observational indexes in the combined treatment group were significantly lower than those in the ibuprofen and hydrocortisone groups, with significant difference between two groups (P<0.05). Incidences of hyperbilirubinemia and gastrointestinal bleeding in the combined treatment group were significantly lower than those in the ibuprofen and hydrocortisone groups, with significant difference between two groups (P<0.05). Conclusion Ibuprofen Suspension combined with Hydrocortisone Acetate Tablets has clinical curative in treatment of patent ductus arteriosus in preterm infants, can decrease the levels of PGE₂, NT-proBNP, and EF-1, and improve cardiac function indexes, which has a certain clinical application value.