超声心动图预测极低出生体重早产儿症状性动脉导管未闭。
Echocardiographic predictors of symptomatic patent ductus arteriosus in extremely-low-birth-weight preterm neonates.
机构信息
Division of Cardiology, Department of Pediatrics, UT Southwestern Medical Center, Dallas, TX, USA.
出版信息
J Perinatol. 2010 Aug;30(8):535-9. doi: 10.1038/jp.2010.14. Epub 2010 Feb 25.
OBJECTIVE
Identify echocardiographic parameters at <or=4 day postnatal that predict the subsequent need for closure of a clinically significant patent ductus arteriosus (sPDA) in extremely-low-birth-weight neonates (ELBW).
STUDY DESIGN
Serial echocardiograms obtained in 115 ELBW at <or=10 day postnatal were examined to estimate PDA size using the PDA:left pulmonary artery (LPA) diameter ratio: >or=1 indicated a large PDA, <1 but >or=0.5 moderate, and <0.5 small. Sensitivity, specificity, and positive predictive values (PPV) were determined for ELBW <27 weeks and >or=27 weeks gestational age.
RESULT
Neonates with moderate to large PDA at <or=4 day had 15-times greater likelihood of requiring treatment for sPDA than those with a small PDA (95% confidence interval (CI): 5.6-41). Sensitivity, specificity and PPV of the PDA:LPA at <27 weeks was 80, 86 and 92%, respectively.
CONCLUSION
A moderate to large PDA determined from the PDA:LPA ratio at <or=4 day postnatal identifies neonates <27 week gestation who subsequently require closure of a PDA.
目的
确定出生后<=4 天的超声心动图参数，以预测极低出生体重儿（ELBW）随后需要关闭临床显著的动脉导管未闭（sPDA）。
研究设计
对 115 例 ELBW 在出生后<=10 天进行了一系列超声心动图检查，使用 PDA：左肺动脉（LPA）直径比来估计 PDA 大小：>or=1 表示大 PDA，<1 但 >or=0.5 为中度，<0.5 为小。确定了<27 周和>or=27 周胎龄的 ELBW 的敏感性、特异性和阳性预测值（PPV）。
结果
出生后<=4 天存在中到大型 PDA 的新生儿，其需要治疗 sPDA 的可能性比存在小 PDA 的新生儿高 15 倍（95%置信区间（CI）：5.6-41）。<27 周时 PDA：LPA 的敏感性、特异性和 PPV 分别为 80%、86%和 92%。
结论
出生后<=4 天的 PDA：LPA 比值中确定的中到大型 PDA，可识别出随后需要关闭 PDA 的<27 周胎龄的新生儿。
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