Pediatric Cardiology, Department of Paediatrics, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy.
Early Hum Dev. 2010 May;86(5):295-8. doi: 10.1016/j.earlhumdev.2010.04.003. Epub 2010 May 20.
To evaluate and compare cardiovascular adaptation of 36 preterm and 34 fullterm newborns, we analyzed BNP concentration and echocardiographic parameters at day 3 of life and at day 28 (+/-2). On day 3 BNP concentrations (pg/ml) resulted higher in PDA preterm group (n=11; 125, IQR 56.1-301) than preterm without PDA (n=25; 25.5 IQR 10.9-49; p<0.001) than fullterms (n=34; 55.1 IQR 23.6-82.7; p=0.013). No difference resulted in all groups at 28days (respectively: 12.7 IQR 4.9-23.8; 15.6 IQR 10-22; 8.9 IQR 5.6-20.6). Because of the newborns' growth, all echocardiographic parameters increased with linear relationship with body weight. On day 3 BNP concentration and echocardiographic parameters were not correlated besides LA/AO in preterms with PDA (p=0.0015). On day 28, BNP was significantly correlated with mVTI (p=0.019), M (p=0.007) and LA (p=0.005) in fullterms and only with LA (p=0.007) in preterms. In conclusion, BNP concentrations and echocardiographic measures confirm that preterm, and fullterm newborns conduct themselves in a similar manner during the transition from foetal to post-natal circulation, reaching low levels at a month of life. The presence of PDA during first days of life has no significant impact in this adaptation. LA is the echocardiographic parameter mostly related to BNP concentration in the newborns.
为了评估和比较 36 名早产儿和 34 名足月儿的心血管适应性,我们分析了出生后第 3 天和第 28 天(+/-2)的 BNP 浓度和超声心动图参数。第 3 天,PDA 早产儿组(n=11;125,IQR56.1-301)的 BNP 浓度(pg/ml)高于无 PDA 的早产儿组(n=25;25.5 IQR10.9-49;p<0.001)和足月儿组(n=34;55.1 IQR23.6-82.7;p=0.013)。28 天时,所有组之间均无差异(分别为:12.7 IQR4.9-23.8;15.6 IQR10-22;8.9 IQR5.6-20.6)。由于新生儿的生长,所有超声心动图参数均与体重呈线性关系增加。第 3 天,除 PDA 早产儿的 LA/AO 外,BNP 浓度与超声心动图参数之间无相关性(p=0.0015)。第 28 天,BNP 与 mVTI(p=0.019)、M(p=0.007)和 LA(p=0.005)在足月儿中呈显著相关,仅与 LA(p=0.007)在早产儿中呈显著相关。总之,BNP 浓度和超声心动图测量结果证实,早产儿和足月儿在从胎儿循环向产后循环过渡期间的表现方式相似,在生命的第一个月达到低水平。出生后第 1 天存在 PDA 对这种适应没有显著影响。LA 是新生儿 BNP 浓度最相关的超声心动图参数。