Wang Liling, Liu Zhijie, Zhang Fengjuan, Xu Haiyan, Wang Haiyan, Zhao Xueqiang
Department of Pediatrics, The First Affiliated Hospital of Shandong First Medical University, Jinan, China.
Department of Medical Ultrasound, The First Affiliated Hospital of Shandong First Medical University, Jinan, China.
Echocardiography. 2023 Mar;40(3):180-187. doi: 10.1111/echo.15513. Epub 2023 Jan 23.
Early screening and dynamic monitoring of pulmonary vascular disease (PVD) in bronchopulmonary dysplasia (BPD) high-risk infants is of great clinical significance. Pulmonary artery acceleration time (PAAT) is a reliable and non-invasive method for assessing PVD in children over 1 year, but to date, few studies have used PAAT to assess pulmonary hemodynamics of preterm infants, especially those with BPD. Through dynamic monitoring the main hemodynamic indicators reflected PVD after birth, this study aimed to assess the value of PAAT in evaluating early PVD in BPD infants.
All 81 preterm infants at risk of BPD were divided into BPD and non-BPD groups according to whether BPD occurred. Clinical characteristics, PAAT, right ventricular ejection time (RVET) and other main hemodynamic indicators at four different time points after birth were studied and compared.
PAAT and PAAT/RVET increased gradually within 72 h after birth in the BPD group (p < .05), but the curve tended to be flat over time after 72 h (p > .05). At PMA32 and 36 weeks, the PAAT (49.7 ± 4.8 vs. 54.8 ± 5.7, p = .001; 50.0 ± 5.3 vs. 57.0 ± 5.3, p = .001) and PAAT/RVET (.33 ± .04 vs. .35 ± .03, p = .001; .34 ± .03 vs. .37 ± .04, p = .001) in BPD group were significantly lower than those in the non-BPD group.
PAAT and PAAT/RVET in the BPD group infants showed different change patterns compared to non-BPD group infants. PAAT can be used as a noninvasive and reliable screening method for screening and dynamic monitoring of PVD in BPD high-risk infants.
对支气管肺发育不良(BPD)高危婴儿进行肺血管疾病(PVD)的早期筛查和动态监测具有重要临床意义。肺动脉加速时间(PAAT)是评估1岁以上儿童PVD的一种可靠且无创的方法,但迄今为止,很少有研究使用PAAT来评估早产儿,尤其是患有BPD的早产儿的肺血流动力学。通过动态监测出生后反映PVD的主要血流动力学指标,本研究旨在评估PAAT在评估BPD婴儿早期PVD中的价值。
将所有81例有BPD风险的早产儿根据是否发生BPD分为BPD组和非BPD组。研究并比较出生后四个不同时间点的临床特征、PAAT、右心室射血时间(RVET)和其他主要血流动力学指标。
BPD组出生后72小时内PAAT和PAAT/RVET逐渐升高(p <.05),但72小时后曲线随时间趋于平缓(p >.05)。在矫正胎龄32周和36周时,BPD组的PAAT(49.7±4.8 vs. 54.8±5.7,p =.001;50.0±5.3 vs. 57.0±5.3,p =.001)和PAAT/RVET(.33±.04 vs..35±.03,p =.001;.34±.03 vs..37±.04,p =.001)显著低于非BPD组。
与非BPD组婴儿相比,BPD组婴儿的PAAT和PAAT/RVET呈现出不同的变化模式。PAAT可作为一种无创且可靠的筛查方法,用于BPD高危婴儿PVD的筛查和动态监测。