Rodriguez R J, Riggs T W
Department of Pediatrics, William Beaumont Hospital, Royal Oak, Michigan 48072.
Am J Cardiol. 1990 Dec 15;66(20):1478-81. doi: 10.1016/0002-9149(90)90538-c.
We studied 14 premature infants with the clinical diagnosis of peripheral pulmonic stenosis (PPS) and 15 normal full-term neonates by echocardiographic Doppler examinations. The PPS group had an average main pulmonary artery (PA) diameter similar to the control group (0.91 vs 0.96 cm, difference not significant), but had smaller branch PA diameters: right PA = 0.41 vs 0.50 cm, p less than 0.001, and left PA = 0.41 vs 0.49 cm, p less than 0.001. The PPS group also had greater peak velocities in the main PA (76 vs 63 cm/s, p less than 0.05), right PA (193 vs 118 cm/s, p less than 0.001) and left PA (187 vs 123 cm/s, p less than 0.001). Similarly, the ratio of peak velocity in the branch/main PA was greater for the PPS group: right/main PA peak velocity = 2.91 vs 1.92, p less than 0.01, and left/main PA peak velocity = 2.73 vs 1.99, p less than 0.05. The calculated right ventricular output for the PPS group was more than the control group: 437 vs 261 ml/min/kg, p less than 0.001. Hematocrits were not done on the control group, but the PPS group had an average hematocrit which was low (34%). It is concluded that patients with PPS have mild underdevelopment of the PA branches, with consequent increased flow velocity and turbulent flow. This turbulent flow may be contributed to by increased cardiac output and mild anemia.
我们通过超声心动图多普勒检查研究了14例临床诊断为周围性肺动脉狭窄（PPS）的早产儿和15例正常足月儿。PPS组主肺动脉（PA）平均直径与对照组相似（0.91对0.96cm，差异无统计学意义），但分支肺动脉直径较小：右肺动脉=0.41对0.50cm，p<0.001，左肺动脉=0.41对0.49cm，p<0.001。PPS组主肺动脉（76对63cm/s，p<0.05）、右肺动脉（193对118cm/s，p<0.001）和左肺动脉（187对123cm/s，p<0.001）的峰值速度也更高。同样，PPS组分支/主肺动脉的峰值速度比更高：右/主肺动脉峰值速度=2.91对1.92，p<0.01，左/主肺动脉峰值速度=2.73对1.99，p<0.05。PPS组计算出的右心室输出量高于对照组：437对261ml/min/kg，p<0.001。对照组未检测血细胞比容，但PPS组平均血细胞比容较低（34%）。结论是，PPS患者的肺动脉分支轻度发育不全，导致流速增加和湍流。这种湍流可能是由于心输出量增加和轻度贫血所致。
