Chang Ling Yi, McCurnin Donald, Yoder Bradley, Shaul Phillip W, Clyman Ronald I
Department of Medicine, University of Colorado, Denver, Colorado 80204, USA.
Pediatr Res. 2008 Mar;63(3):299-302. doi: 10.1203/PDR.0b013e318163a8e4.
Premature newborn baboons [125 d (67%) gestation], exposed to a moderate-size patent ductus arteriosus (PDA) [pulmonary-to-systemic blood-flow-ratio (Qp/Qs) = 1.8] for 14 d, have impaired pulmonary function and arrested alveolar development and surface area when compared with age matched fetuses (140 d gestation). Pharmacologic closure of the PDA reduces the detrimental effects of preterm delivery on pulmonary function and surface area. We used preterm baboons (delivered at 125 d gestation and ventilated for 14 d) to study the effects of surgical PDA ligation on pulmonary function and alveolar surface area. After ligation (on day of life 6), ligated animals had lower Qp/Qs ratios [Qp/Qs (ligated, n = 10) = 1.00 +/- 0.04; (nonligated, n = 12) = 2.05 +/- 0.17; mean +/- SD] and higher systemic blood pressures than nonligated control animals. Ventilation and oxygenation indices did not differ between the groups, during either the pre- or postoperative periods. Alveolar surface area measurements were made by digital image analysis and compared with measurements made from fetal lungs at 125 d (n = 6) and 140 d (n = 7) gestation. PDA ligation failed to improve the postnatal arrest in alveolar surface area. In contrast with pharmacologic closure of the PDA, surgical closure failed to improve either pulmonary function or alveolar surface area in baboons with a moderate PDA shunt.
早产狒狒（妊娠125天，占67%）暴露于中等大小的动脉导管未闭（PDA）（肺循环与体循环血流量之比[Qp/Qs]=1.8）14天，与年龄匹配的胎儿（妊娠140天）相比，其肺功能受损，肺泡发育和表面积停滞。PDA的药物性闭合可减轻早产对肺功能和表面积的有害影响。我们使用早产狒狒（妊娠125天分娩并通气14天）来研究手术结扎PDA对肺功能和肺泡表面积的影响。结扎后（出生后第6天），结扎组动物的Qp/Qs比值较低[Qp/Qs（结扎组，n=10）=1.00±0.04；（未结扎组，n=12）=2.05±0.17；平均值±标准差]，且体循环血压高于未结扎的对照动物。在术前或术后期间，两组的通气和氧合指数均无差异。通过数字图像分析测量肺泡表面积，并与妊娠125天（n=6）和140天（n=7）的胎儿肺的测量值进行比较。PDA结扎未能改善出生后肺泡表面积的停滞。与PDA的药物性闭合相反，手术闭合未能改善患有中度PDA分流的狒狒的肺功能或肺泡表面积。
