目的 观察不同日龄的早产儿使用布洛芬治疗有血流动力学意义的动脉导管未闭（hemodynamically significant patent ductus arteriosus, hsPDA）的有效性和安全性。 方法 回顾性分析2020年1月—2023年12月石家庄市第四医院新生儿科中胎龄<37周且使用布洛芬治疗hsPDA的患儿资料，将符合标准的100例患儿按照首次布洛芬治疗的日龄分成3组，其中4日龄内用药的为A组，5~7日龄内用药的为B组，7日龄以后用药的为C组。观察比较3组之间临床疗效及安全性指标的差异。 结果 经治疗，A组的治愈率为92%，有效率为8%；B组的治愈率为72％，有效率为25%；C组的治愈率为60％，有效率为33%，3组间临床疗效差异有统计学意义（P<0.05）。治疗后3组患儿肺出血、消化道出血、胆汁淤积、支气管肺发育不良、坏死性小肠结肠炎、颅内出血、急性肾功能损伤的发生率比较差异均无统计学意义（P>0.05）。 结论 对于需要药物治疗的hsPDA，越早口服布洛芬，动脉导管闭合率越高，且不会增加不良事件的发生率。

Objective To evaluate the efficacy and safety of ibuprofen in treating hemodynamically significant patent ductus arteriosus (hsPDA) in preterm infants of different postnatal ages at treatment initiation. Methods Clinical records of infants with gestational age <37 weeks who received ibuprofen for hsPDA in the Department of Neonatology, Fourth Hospital of Shijiazhuang, from January 2020 to December 2023 were retrospectively reviewed. One hundred eligible infants were divided by the postnatal age at the first ibuprofen administration into three groups: group A (≤4 days), group B (5-7 days), and group C (>7 days). Clinical efficacy and safety indicators were compared among groups. Results After treatment, cure rates were 92% in group A, 72% in group B, and 60% in group C, and effective rates were 8%, 25%, and 33%, respectively. Differences in clinical efficacy among the three groups were statistically significant (P<0.05). No significant differences were observed among groups in the incidence of pulmonary hemorrhage, gastrointestinal bleeding, cholestasis, bronchopulmonary dysplasia, necrotizing enterocolitis, intracranial hemorrhage, or acute kidney injury (P>0.05). Conclusions For hsPDA requiring pharmacologic therapy, earlier oral ibuprofen administration yields a higher ductal closure rate and does not increase the incidence of adverse events.