Cheliakine-Chamboux C, Chantepie A, Godde F, Vaillant M C, Saliba E, Gold F, Laugier J
Unité de Réanimation Pédiatrique, Hôpital G. de Clocheville, Tours.
Therapie. 1991 May-Jun;46(3):231-3.
In order to estimate the efficacity of prostaglandine E1 (PGE1) to dilate the obstruction in coarctation of the aorta (CoAo), we studied 16 full term neonates with heart failure. Over the 16 neonates, there was 5 with isolated CoAo and 11 with an intracardiac shunt. Over the 11 neonates, 7 had pulmonary hypertension. PGE1, at a dose of 0.05 microgram/kg/min associated to the classical treatment of heart failure were given on the 6 day of life. Effects of PGE1 were evaluated on clinical basis (presence of femoral pulse, blood pressure), echocardiographical basis (ductus arteriosus and aortic isthmus diameter) and morphological basis. In 15 neonates, the ductus arteriosus was open, in all cases CoAo diameter was the same. In 7 neonates with pulmonary hypertension, femoral pulse appeared. In conclusion, PGE1 increases post ductal perfusion by a right to left shunt through the ductus arteriosus, only in cases where pulmonary hypertension is present. No direct action on the aortic isthmus was observed.
为评估前列腺素E1(PGE1)扩张主动脉缩窄(CoAo)梗阻的疗效,我们研究了16例患有心力衰竭的足月新生儿。在这16例新生儿中,5例为单纯CoAo,11例伴有心内分流。在这11例新生儿中,7例患有肺动脉高压。在出生后第6天给予剂量为0.05微克/千克/分钟的PGE1并联合心力衰竭的经典治疗。基于临床(股动脉搏动、血压)、超声心动图(动脉导管和主动脉峡部直径)及形态学对PGE1的效果进行评估。15例新生儿的动脉导管开放,所有病例中CoAo直径相同。7例患有肺动脉高压的新生儿出现了股动脉搏动。总之,仅在存在肺动脉高压的情况下,PGE1通过经动脉导管的右向左分流增加导管后灌注。未观察到对主动脉峡部的直接作用。