Tanaka Yuko, Hayashi Tomoshige, Kitajima Hiroyuki, Sumi Kiyoaki, Fujimura Masanori
Department of Neonatal Medicine, Osaka Medical Center and Research Institute for Maternal and Child Health, 840 Murodo-cho, Izumi, Osaka 594-1101, Japan.
Pediatrics. 2007 Jun;119(6):1159-64. doi: 10.1542/peds.2006-2269.
The aim was to determine whether inhaled nitric oxide therapy improves neurodevelopmental outcomes for infants with preterm persistent pulmonary hypertension of the newborn.
We conducted a historical cohort study to compare the 3-year incidence of cerebral palsy in preterm singleton infants (< 34 gestational weeks) with hypoxemic respiratory failure caused by persistent pulmonary hypertension of the newborn who received inhaled nitric oxide (16 patients) or 100% oxygen (15 patients) therapy. All neonates had clinical and echocardiographic evidence of pulmonary hypertension without structural heart disease.
The incidence of cerebral palsy among patients treated with inhaled nitric oxide was 12.5%, whereas that among patients treated with 100% oxygen was 46.7%. After adjustment for maternal fever (> or = 38 degrees C) during delivery, birth weight, Apgar score at 5 minutes, high-frequency oscillatory ventilation, and surfactant therapy, inhaled nitric oxide therapy, compared with 100% oxygen therapy, was associated with a decreased risk of cerebral palsy in preterm infants with persistent pulmonary hypertension of the newborn.
Inhaled nitric oxide therapy decreases the risk of cerebral palsy in preterm infants with persistent pulmonary hypertension of the newborn.
旨在确定吸入一氧化氮疗法是否能改善患有新生儿持续性肺动脉高压的早产婴儿的神经发育结局。
我们进行了一项历史性队列研究，以比较单胎早产儿（孕周<34周）因新生儿持续性肺动脉高压导致低氧性呼吸衰竭，接受吸入一氧化氮治疗（16例）或100%氧气治疗（15例）后的3年脑瘫发病率。所有新生儿均有肺动脉高压的临床和超声心动图证据，且无结构性心脏病。
吸入一氧化氮治疗的患者中脑瘫发病率为12.5%，而接受100%氧气治疗的患者中脑瘫发病率为46.7%。在对分娩期间母亲发热（≥38℃）、出生体重、5分钟阿氏评分、高频振荡通气和表面活性剂治疗进行调整后，与100%氧气治疗相比，吸入一氧化氮治疗与患有新生儿持续性肺动脉高压的早产婴儿脑瘫风险降低相关。
吸入一氧化氮疗法可降低患有新生儿持续性肺动脉高压的早产婴儿患脑瘫的风险。
