Department of Paediatrics, Halmstad Hospital, Sweden.
Acta Paediatr. 2011 Feb;100(2):231-5. doi: 10.1111/j.1651-2227.2010.02027.x. Epub 2010 Oct 13.
To evaluate the efficacy of various echocardiographic markers in predicting a patent ductus arteriosus (PDA) in need of treatment.
Forty-five preterm infants with a mean (SD) gestational age of 27.7 (1.9) weeks underwent echocardiography at a postnatal age of 24 ± 6 and 72 ± 6 h. Four echocardiographic markers were studied: ductus diameter, ductal flow Doppler curves, the left atrial to aortic root (LA/Ao) ratio and Doppler pixels representing ductal shunting.
Twenty-eight infants had a PDA with a detectable left-to-right shunt. Of these, 12 (43%) were treated for a shunt through the PDA. Ductal diameter was the most accurate echocardiographic marker when it came to predicting a significant shunt, with a sensitivity of 89%, a specificity of 70%, a positive likelihood ratio of 2.97 and a negative likelihood ratio of 0.16 at the age of 72 h. The efficacy of the method at 72 h of age was 84%. The corresponding efficacy of the pulsatile Doppler curve was 72%, percentage of green colour pixels 63% and the LA/Ao ratio 53%.
Ductus diameter appears to be the most important variable in determining the need for therapeutic intervention for PDA in preterm infants.
评估各种超声心动图标志物在预测需要治疗的动脉导管未闭（PDA）中的作用。
45 名胎龄为 27.7（1.9）周的早产儿在出生后 24 ± 6 和 72 ± 6 小时进行了超声心动图检查。研究了 4 种超声心动图标志物：导管直径、导管内血流多普勒曲线、左心房与主动脉根部（LA/Ao）比值和代表导管分流的多普勒像素。
28 名婴儿有可检测到的左向右分流的 PDA。其中，12 名（43%）因 PDA 分流而接受治疗。在预测显著分流方面，导管直径是最准确的超声心动图标志物，在 72 小时时的灵敏度为 89%，特异性为 70%，阳性似然比为 2.97，阴性似然比为 0.16。该方法在 72 小时时的有效性为 84%。脉动多普勒曲线的相应有效性为 72%，绿色像素百分比为 63%，LA/Ao 比值为 53%。
导管直径似乎是决定早产儿 PDA 是否需要治疗干预的最重要变量。
