早产儿单支病变的主肺动脉狭窄。
Primary pulmonary vein stenosis among premature infants with single-vessel disease.
机构信息
Center for Perinatal Research, The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA.
The Heart Center at Nationwide Children's Hospital, Columbus, OH, USA.
出版信息
J Perinatol. 2021 Jul;41(7):1621-1626. doi: 10.1038/s41372-020-00830-9. Epub 2020 Sep 25.
OBJECTIVES
Describe outcomes among preterm infants diagnosed with single-vessel primary pulmonary vein stenosis (PPVS) initially treated using conservative management (active surveillance with deferral of treatment).
STUDY DESIGN
Retrospective cohort study at a single, tertiary-center (2009-2019) among infants <37 weeks' gestation with single-vessel PPVS. Infants were classified into two categories: disease progression and disease stabilization. Cardiopulmonary outcomes were examined, and a Kaplan-Meier survival analysis performed.
RESULTS
Twenty infants were included. Compared to infants in the stable group (0/10, 0%), all infants in the progressive group had development of at least severe stenosis or atresia (10/10, 100%; P < 0.01). Severe pulmonary hypertension at diagnosis was increased in the progressive (5/10, 50%) versus the stable group (0/10, 0%; P = 0.03). Survival was lower among infants in the progressive than the stable group (log-rank test, P < 0.01).
CONCLUSION
Among preterm infants with single-vessel PPVS, risk stratification may be possible, wherein more targeted, individualized therapies could be applied.
目的
描述经保守治疗（主动监测并延迟治疗）初始治疗的单支原发性肺静脉狭窄（PPVS）早产儿的结局。
研究设计
对单中心（2009-2019 年）<37 周胎龄的单支 PPVS 婴儿进行回顾性队列研究。将婴儿分为两类：疾病进展和疾病稳定。检查心肺结局，并进行 Kaplan-Meier 生存分析。
结果
纳入 20 名婴儿。与稳定组（0/10，0%）相比，进展组所有婴儿均出现至少严重狭窄或闭锁（10/10，100%；P<0.01）。进展组（5/10，50%）与稳定组（0/10，0%）相比，诊断时严重肺动脉高压的发生率增加（P=0.03）。进展组婴儿的生存率低于稳定组（对数秩检验，P<0.01）。
结论
在患有单支 PPVS 的早产儿中，可能可以进行风险分层，从而可以应用更有针对性、个体化的治疗方法。
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