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胎龄小于 32 周的早产儿,其动脉导管未闭的自发闭合几率较高,且该几率在随访至 5 年时仍持续增加。

The chance of spontaneous patent ductus arteriosus closure in preterm infants born before 32 weeks of gestation is high and continues to increase until 5 years of follow-up.

机构信息

Department of Paediatric and Adolescent Medicine, Aalborg University Hospital, Aalborg, Denmark.

出版信息

Acta Paediatr. 2022 Dec;111(12):2322-2330. doi: 10.1111/apa.16541. Epub 2022 Sep 28.

Abstract

AIM

The primary aim was to estimate premature infants' spontaneous patent ductus arteriosus closure rate. Secondly, to identify criteria associated with the chance of spontaneous closure.

METHODS

We performed a retrospective cohort study of 167 infants born before 32 weeks of gestation and diagnosed with a patent ductus arteriosus between 1 January 2008 and 31 December 2017. The spontaneous patent ductus arteriosus closure event rate was evaluated using the Kaplan-Meier estimator.

RESULTS

The spontaneous closure rate within the first year of life was 66% (95% CI 58%-73%), increasing to 80% (95% CI 72%-86%) five years after birth. When including both spontaneous closure and closure following treatment, 96% (95% CI 86%-100%) closed within 5 years after birth. The chance of spontaneous closure was reduced in the case of a large patent ductus arteriosus: OR 0.16 (95% CI 0.05-0.52), left atrial enlargement: OR 0.16 (95% CI 0.05-0.51), and pulmonary hypertension: OR 0.23 (95% CI 0.07-0.74).

CONCLUSION

The chance of spontaneous closure in premature infants born between 23 and 32 weeks of gestation was high, and the incidence continued increasing until 5 years of follow-up.

摘要

目的

主要目的是估计早产儿自发性动脉导管未闭的闭合率。其次,确定与自发性闭合机会相关的标准。

方法

我们对 2008 年 1 月 1 日至 2017 年 12 月 31 日期间出生胎龄小于 32 周且诊断为动脉导管未闭的 167 名婴儿进行了回顾性队列研究。使用 Kaplan-Meier 估计器评估自发性动脉导管未闭闭合事件的发生率。

结果

出生后 1 年内自发性闭合率为 66%(95%CI 58%-73%),5 年后增加至 80%(95%CI 72%-86%)。包括自发性闭合和治疗后闭合在内,96%(95%CI 86%-100%)在出生后 5 年内闭合。动脉导管未闭较大时,自发性闭合的机会降低:OR 0.16(95%CI 0.05-0.52),左心房增大:OR 0.16(95%CI 0.05-0.51),和肺动脉高压:OR 0.23(95%CI 0.07-0.74)。

结论

胎龄在 23 至 32 周之间的早产儿自发性动脉导管未闭闭合的机会较高,并且这种发生率在 5 年随访中持续增加。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3e0f/9827876/1a9da2e03a43/APA-111-2322-g002.jpg

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