低剂量二氧化在患有过渡性高胰岛素症的婴儿中是安全有效的
Neha Malhotra1, Daphne Yau2, Annaruby Cunjamalay1
1Endocrinology Department, Great Ormond Street Hospital for Children, London, UK.
Clinical endocrinology
|December 7, 2023
概括
低剂量的氧化物,低于5mg/kg/day,有效地治疗新生儿的过渡性高胰岛素症 (THI). 起始剂量为2-3毫克/公斤/天,平衡疗效,在THI管理中减少不良事件.
科学领域:
- 新生儿科学 新生儿科学
- 儿科内分泌学 儿科内分泌学
- 药理学 药理学是指药理学的学科.
背景情况:
- 过渡性高胰岛素 (THI) 是新生儿低血糖症的常见原因,超过生命的第一个星期.
- 目前的指导方针建议用于THI的氧化物剂量为5-15 mg/kg/day,平衡有效性与潜在的不良事件.
- 在THI中较低的氧化剂量 (<5 mg/kg/day) 的有效性需要进一步研究.
研究的目的:
- 评估在治疗新生儿短暂高胰岛素症 (THI) 时,低于5mg/kg/天的二氧化剂量的疗效和安全性.
- 确定较低的二氧化初始剂量是否可以有效地管理THI,同时最大限度地减少不良事件.
主要方法:
- 在2015年10月至2021年2月期间,对73名THI婴儿进行了回顾性研究,这些婴儿接受了低剂量二氧化 (2-5 mg/kg/天) 治疗.
- 婴儿被分为基于体重的队列,分为每天2毫克/公斤,每天3毫克/公斤或每天5毫克/公斤的初始剂量.
- 收集的数据包括二氧化剂量,治疗时间,需要增加剂量和不良事件.
主要成果:
- 平均有效的二氧化剂量为3 mg/kg/天,剂量<5 mg/kg/天在治疗THI方面有效.
- 18%的婴儿出现了不良事件,主要是轻微的事件,如胀和低血症;两名婴儿怀疑死亡性肠球炎.
- 在35%的婴儿中,需要增加剂量,在最低起始剂量队列中,这一比例更高.
结论:
- 低于5mg/kg/天的氧化物剂量对于治疗新生儿过渡性高胰岛素症是有效的.
- 从2-3毫克/公斤/天开始服用氧化物,可以提供有效性和安全性之间的有利平衡,降低不良事件的风险.
- 虽然与死性肠球炎的关联需要进一步研究,但较低剂量的二氧化似乎对THI安全有效.
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