Tsuda Hiroyuki, Kotani Tomomi, Miura Mayo, Ito Yumiko, Hirako Shima, Nakano Tomoko, Imai Kenji, Kikkawa Fumitaka
a Department of Obstetrics and Gynecology , Nagoya University Graduate School of Medicine , Nagoya , Japan.
J Matern Fetal Neonatal Med. 2017 Jul;30(13):1509-1513. doi: 10.1080/14767058.2017.1299126. Epub 2017 Mar 9.
Congenital diaphragmatic hernia (CDH) causes pulmonary hypoplasia and pulmonary hypertension, which are associated with long-term respiratory problems in infants. The aim of this study was to establish a marker for predicting lung function at 1 year of age in infants with CDH.
Infants with isolated CDH who were delivered after 35 weeks of gestation from April 2008 to June 2016 at Nagoya University Hospital were registered. Regarding alive infants with CDH, only those who underwent follow-up for at least 1 year were registered. Finally, 48 infants were analyzed in this study.
Gestational age at diagnosis, amniotic lamellar body count at birth, observed-to-expected MRI fetal lung volume (percent FLV), liver herniation, and polyhydramnios were found to be significant parameters for predicting mortality in infants with CDH. Regarding alive infants with CDH, percent FLV was the only significant parameter to predict need for oxygen therapy at 1 year of age (p < .05). There was a significant negative correlation between percent FLV and duration of oxygen therapy in infants with CDH (r = .516, p < .001).
Percent FLV is a useful predictor of long-term lung morbidity in infants with CDH.
先天性膈疝(CDH)会导致肺发育不全和肺动脉高压,这与婴儿的长期呼吸问题相关。本研究的目的是建立一个预测CDH婴儿1岁时肺功能的标志物。
登记2008年4月至2016年6月在名古屋大学医院妊娠35周后分娩的孤立性CDH婴儿。对于存活的CDH婴儿,仅登记那些接受了至少1年随访的婴儿。最终,本研究分析了48例婴儿。
诊断时的孕周、出生时羊膜板层小体计数、观察到的与预期的MRI胎儿肺体积(肺体积百分比)、肝脏疝出和羊水过多被发现是预测CDH婴儿死亡率的重要参数。对于存活的CDH婴儿,肺体积百分比是预测1岁时是否需要氧疗的唯一重要参数(p < 0.05)。CDH婴儿的肺体积百分比与氧疗持续时间之间存在显著负相关(r = 0.516,p < 0.001)。
肺体积百分比是CDH婴儿长期肺部发病情况的有用预测指标。