对乙酰氨基酚会对易感婴幼儿的神经发育造成损伤:争议的理由并不充分。

IF 3.2 Q1 PEDIATRICS
Clinical and Experimental Pediatrics Pub Date : 2024-03-01 Epub Date: 2023-06-14 DOI:10.3345/cep.2022.01319
Lisa Zhao, John P Jones, Lauren G Anderson, Zacharoula Konsoula, Cynthia D Nevison, Kathryn J Reissner, William Parker
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引用次数: 0

摘要

尽管对乙酰氨基酚(APAP)被全世界公认为儿科的必备药物,但十多年来,越来越多的证据表明,早期接触对乙酰氨基酚(APAP)会导致易感婴幼儿的神经发育损伤。证据多种多样,包括对实验室动物的大量研究、无法解释的关联、与 APAP 代谢有关的因素以及对人类的有限研究。尽管这些证据已经达到了压倒性的程度,而且最近还进行了详细的回顾,但争议依然存在。本叙述性综述对其中的一些争议进行了评估。我们考虑了产前和产后的证据,以避免因仅考虑产前风险的有限证据而引发争议。除其他问题外,还考虑了使用 APAP 与神经发育障碍患病率之间的关系。系统性回顾显示,从未对 APAP 在儿科人群中的使用情况进行过仔细跟踪;不过,影响其使用的历史事件已被记录在案,足以确定其与神经发育障碍患病率变化之间的明显相关性。此外,我们还回顾了完全依赖于药物暴露时间有限的大型数据集的荟萃分析结果所存在的问题。此外,我们还研究了为什么有些儿童容易受到 APAP 引起的神经发育损伤的证据。我们的结论是,现有证据表明,早期接触 APAP 会对易受影响的婴儿和幼儿造成神经发育损伤。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Acetaminophen causes neurodevelopmental injury in susceptible babies and children: no valid rationale for controversy.

Despite the worldwide acceptance of acetaminophen (APAP) as a necessary medicine in pediatrics, evidence that early exposure to APAP causes neurodevelopmental injury in susceptible babies and children has been mounting for over a decade. The evidence is diverse and includes extensive work with laboratory animals, otherwise unexplained associations, factors associated with APAP metabolism, and limited studies in humans. Although the evidence has reached an overwhelming level and was recently reviewed in detail, controversy persists. This narrative review evaluates some of that controversy. Evidence from the pre- and postpartum periods was considered to avoid controversy raised by consideration of only limited evidence of risks during the prepartum period. Among other issues, the association between APAP use and the prevalence of neurodevelopmental disorders was considered. A systematic review revealed that the use of APAP in the pediatric population was never tracked carefully; however, historical events that affected its use were documented and are sufficient to establish apparent correlations with changes in the prevalence of neurodevelopmental disorders. Moreover, problems with the exclusive reliance on results of meta-analyses of large datasets with limited time frames of drug exposure were reviewed. Furthermore, the evidence of why some children are susceptible to APAPinduced neurodevelopmental injuries was examined. We concluded that available evidence demonstrates that early exposure to APAP causes neurodevelopmental injury in susceptible babies and small children.

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来源期刊
CiteScore
8.00
自引率
2.40%
发文量
88
审稿时长
60 weeks
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