Cua C L, Blankenship A, North A L, Hayes J, Nelin L D
Department of Pediatrics, Section of Cardiology, Columbus Children's Hospital and The Ohio State University, 700 Children's Drive, Columbus, OH 43205-2696, USA.
Pediatr Cardiol. 2007 Jul-Aug;28(4):250-4. doi: 10.1007/s00246-006-0011-6. Epub 2007 May 5.
Down syndrome (DS) patients have an increased risk of developing pulmonary hypertension later in life compared to age-matched controls. The goal of this study was to determine if the incidence of persistent pulmonary hypertension of the newborn (PPHN) is also higher in neonatal DS patients compared to the general population. A retrospective chart review of DS patients admitted during a 3-year period to the neonatal intensive care unit was performed. DS patients with meconium aspiration syndrome, pulmonary infections, or pulmonary space-occupying lesions were excluded. DS patients were divided into four groups based on treatment and consisted of no intervention (A), supplemental oxygen (B,) mechanical ventilation use (C), and inhaled nitric oxide administration (D). Group D was defined as having PPHN. z test of the difference between sample and known population, chi-square, t-test, and analysis of variance with Tukey adjusted post hoc test were used for analysis. p<0.05 was considered significant. A total of 58 patients met inclusion criteria. Twenty-four DS patients were in group A, 17 in group B, 10 in group C, and 7 in group D. There was no difference between the four groups for gender (males: 10, 5, 5, and 5, respectively), gestational age (36.4, 38.2, 36.4, and 36.4 weeks, respectively), weight (2.8, 3.0, 2.4, and 3.0 kg, respectively), or the presence of congenital heart defects (17, 10, 6, and 1, respectively). The estimated number of DS patients born in the state of Ohio during this period was 598; therefore, the incidence of PPHN in DS was 1.2%. The reported incidence of PPHN is 0.1%. The reported incidence of PPHN was significantly lower versus the incidence of PPHN in DS (z=2.7, p=0.007). It was concluded that DS patients have an increased incidence of PPHN compared to historical controls regardless of baseline demographics.
与年龄匹配的对照组相比，唐氏综合征（DS）患者在晚年发生肺动脉高压的风险增加。本研究的目的是确定与一般人群相比，新生儿DS患者持续性肺动脉高压（PPHN）的发生率是否也更高。对在3年期间入住新生儿重症监护病房的DS患者进行了回顾性病历审查。排除患有胎粪吸入综合征、肺部感染或肺部占位性病变的DS患者。DS患者根据治疗方法分为四组，分别为不干预（A组）、补充氧气（B组）、使用机械通气（C组）和吸入一氧化氮（D组）。D组被定义为患有PPHN。采用样本与已知总体差异的z检验、卡方检验、t检验以及经Tukey校正的事后检验的方差分析进行分析。p<0.05被认为具有统计学意义。共有58名患者符合纳入标准。A组有24名DS患者，B组17名，C组10名，D组7名。四组在性别（男性分别为10名、5名、5名和5名）、胎龄（分别为36.4周、38.2周、36.4周和36.4周）、体重（分别为2.8 kg、3.0 kg、2.4 kg和3.0 kg）或先天性心脏缺陷的存在情况（分别为17例、10例、6例和1例）方面没有差异。在此期间，俄亥俄州出生的DS患者估计有598名；因此，DS患者中PPHN的发生率为1.2%。报告的PPHN发生率为0.1%。报告的PPHN发生率显著低于DS患者中PPHN的发生率（z=2.7，p=0.007）。得出的结论是，无论基线人口统计学特征如何，与历史对照组相比，DS患者PPHN的发生率增加。
