早产儿早期呼吸疾病模式与舒张功能障碍的关系。
The association between patterns of early respiratory disease and diastolic dysfunction in preterm infants.
机构信息
John Hunter Children's Hospital, department of neonatology, Newcastle, NSW, Australia.
University of Newcastle, Newcastle, NSW, Australia.
出版信息
J Perinatol. 2023 Oct;43(10):1268-1273. doi: 10.1038/s41372-023-01608-5. Epub 2023 Feb 23.
BACKGROUND
This study aims to determine the association between clinical patterns of early respiratory disease and diastolic dysfunction in preterm infants.
METHODS
Preterm infants <29 weeks' gestation underwent cardiac ultrasounds around day 7 and 14-21. Respiratory dysfunction patterns were classified as stable (ST), respiratory deterioration (RD) or early persistent respiratory dysfunction (EPRD) according to oxygen need. Diastolic dysfunction was diagnosed using a multi-parameter approach including left atrial strain (LAS) to help differentiate between cardiac or pulmonary pathophysiology.
RESULTS
98 infants (mean 27 weeks) were included. The prevalence of ST, RD and EPRD was 53%, 21% and 26% respectively. Diastolic dysfunction was more prevalent in the RD and EPRD groups with patent ductus arteriosus and significant growth restriction as risk factors. Not all infants with a PDA developed diastolic dysfunction. LAS was lower in the EPDR group.
CONCLUSION
Respiratory dysfunction patterns are associated with diastolic dysfunction in preterm infants.
背景
本研究旨在确定早产儿早期呼吸疾病的临床模式与舒张功能障碍之间的关联。
方法
胎龄<29 周的早产儿在出生后第 7 天和 14-21 天左右进行心脏超声检查。根据氧需求，将呼吸功能障碍模式分为稳定型（ST）、呼吸恶化型（RD）或早期持续呼吸功能障碍型（EPRD）。舒张功能障碍采用多参数方法诊断，包括左心房应变（LAS），以帮助区分心脏或肺病理生理学。
结果
98 例婴儿（平均胎龄 27 周）纳入研究。ST、RD 和 EPRD 的发生率分别为 53%、21%和 26%。RD 和 EPRD 组中，存在动脉导管未闭和明显生长受限的婴儿舒张功能障碍更为常见，这些是其危险因素。并非所有患有动脉导管未闭的婴儿都出现舒张功能障碍。EPRD 组的 LAS 较低。
结论
早产儿的呼吸功能障碍模式与舒张功能障碍相关。
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