De Simone L, Cecchi F, Favilli S, Pollini I, Taiti A, Fiorini P, Manetti A
Unità Operativa di Cardiologia, Ospedale A. Meyer, Firenze.
G Ital Cardiol. 1991 Apr;21(4):409-14.
In preterm infants patent ductus arteriosus (PDA) may worsen the clinical course of Respiratory Distress Syndrome (RDS). Indomethacin is usually effective in producing duct closure in the first days of life, but clinical diagnosis is often difficult to perform in these patients. In recent years Pulsed Doppler Cross-Sectional Echocardiography (PD-CSE) has made it possible to identify the duct and to assess noninvasively the characteristics of blood flow within it. The aim of this study was to verify the utility of PD-CSE in the early diagnosis of PDA and to provide the basis for a more effective drug therapy. Among 51 patients with RDS, a significant PDA was evidenced in 20 with PD-CSE and in only 8/20 with physical and E-TM examination (p less than 0.01). Indomethacin administration produced duct closure in 19/20 patients (95%). In this study PD-CSE has been more sensitive than the other noninvasive procedures in the diagnosis of PDA; moreover, the success with drug therapy demonstrates the utility of this procedure in providing the basis of a more effective treatment of the duct.
在早产儿中,动脉导管未闭(PDA)可能会使呼吸窘迫综合征(RDS)的临床病程恶化。吲哚美辛通常在生命的最初几天对促使导管闭合有效,但在这些患者中临床诊断往往难以进行。近年来,脉冲多普勒横截面超声心动图(PD-CSE)使得识别导管并无创评估其内部血流特征成为可能。本研究的目的是验证PD-CSE在PDA早期诊断中的效用,并为更有效的药物治疗提供依据。在51例RDS患者中,PD-CSE证实20例存在显著的PDA,而体格检查和心电图检查仅在8/20例中发现(p<0.01)。19/20例患者(95%)使用吲哚美辛后导管闭合。在本研究中,PD-CSE在PDA诊断中比其他无创检查更敏感;此外,药物治疗的成功证明了该检查在为更有效治疗导管提供依据方面的效用。