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原发性纤毛运动障碍新生儿的呼吸窘迫

Respiratory Distress in the Newborn with Primary Ciliary Dyskinesia.

作者信息

Machogu Evans, Gaston Benjamin

机构信息

Section of Pediatric Pulmonology, Allergy and Sleep Medicine, Indiana University School of Medicine, Riley Hospital for Children, Indianapolis, IN 46202, USA.

出版信息

Children (Basel). 2021 Feb 18;8(2):153. doi: 10.3390/children8020153.

Abstract

Primary ciliary dyskinesia (PCD) is inherited in a predominantly autosomal recessive manner with over 45 currently identified causative genes. It is a clinically heterogeneous disorder that results in a chronic wet cough and drainage from the paranasal sinuses, chronic otitis media with hearing impairment as well as male infertility. Approximately 50% of patients have situs inversus totalis. Prior to the development of chronic oto-sino-pulmonary symptoms, neonatal respiratory distress occurs in more than 80% of patients as a result of impaired mucociliary clearance and mucus impaction causing atelectasis and lobar collapse. Diagnosis is often delayed due to overlapping symptoms with other causes of neonatal respiratory distress. A work up for PCD should be initiated in the newborn with compatible clinical features, especially those with respiratory distress, consistent radiographic findings or persistent oxygen requirement and/or organ laterality defects.

摘要

原发性纤毛运动障碍(PCD)主要以常染色体隐性方式遗传,目前已确定45多种致病基因。它是一种临床异质性疾病,可导致慢性湿性咳嗽、鼻窦引流、伴有听力障碍的慢性中耳炎以及男性不育。约50%的患者有全内脏转位。在慢性耳-鼻-肺症状出现之前,超过80%的患者会因黏液纤毛清除功能受损和黏液嵌塞导致肺不张和肺叶萎陷而出现新生儿呼吸窘迫。由于与新生儿呼吸窘迫的其他病因症状重叠,诊断往往会延迟。对于具有相符临床特征的新生儿,尤其是那些有呼吸窘迫、一致的影像学表现或持续需要吸氧和/或器官位置异常的新生儿,应启动PCD的检查。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d598/7922088/a2030f8a5182/children-08-00153-g001.jpg

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