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预测早产儿动脉导管自然闭合的超声心动图参数。

Echocardiographic parameters predicting spontaneous closure of ductus arteriosus in preterm infants.

作者信息

He Minyu, Yang Zhengchun, Gan Tian, Tang Jing, Ran Suzhen, Zhang Kun

机构信息

Department of Ultrasound, Chongqing Health Center for Women and Children, Chongqing, China.

Department of Ultrasound, Women and Children's Hospital of Chongqing Medical University, Chongqing, China.

出版信息

Front Pediatr. 2023 Jun 15;11:1198936. doi: 10.3389/fped.2023.1198936. eCollection 2023.

Abstract

OBJECTIVE

To evaluate the value of echocardiographic parameters in predicting early spontaneous closure of ductus arteriosus in premature infants.

METHODS

222 premature infants admitted to the neonatal ward of our hospital were selected, and patent ductus arteriosus was detected by echocardiography 48 h after birth. On the 7th day, whether the ductus arteriosus was closed naturally in this cohort was observed. The infants whose ductus arteriosus were not closed were identified as the PDA group ( = 109), and the other infants were included in the control group ( = 113). The echocardiographic parameters of the two groups of premature infants at 48 h after birth were single-factor statistically and Pearson correlation analyzed, and the parameters with statistically significant differences in single-factor analyzed were selected for multivariate logistic stepwise regression analysis.

RESULTS

The ductus arteriosus shunt velocity and the pressure difference between the descending aorta and the pulmonary artery (ΔPs) in the PDA group were lower than those in the control group ( < 0.05). The pulmonary artery pressure (PASP) in the PDA group was higher than that in the control group ( < 0.05). According to the multivariate logistic stepwise regression analysis, only the maximum shunt velocity of ductus arteriosus was correlated with early spontaneous closure of ductus arteriosus in 48 h first echocardiographic parameters ( = 0.049). The receiver operating characteristic (ROC) curve indicates the optimal critical point of echocardiographic ductus arteriosus shunt velocity in premature infants 48 h after birth was 1.165 m/s.

CONCLUSION

Echocardiographic parameters are of great value in predicting the early spontaneous closure of ductus arteriosus in premature infants. In particular, the ductus arteriosus shunt velocity is correlated with the early spontaneous closure of ductus arteriosus.

摘要

目的

评估超声心动图参数对早产儿动脉导管早期自然闭合的预测价值。

方法

选取我院新生儿病房收治的222例早产儿,出生后48小时行超声心动图检查以检测动脉导管未闭情况。在第7天,观察该队列中动脉导管是否自然闭合。动脉导管未闭合的婴儿被确定为动脉导管未闭组(n = 109),其他婴儿纳入对照组(n = 113)。对两组早产儿出生后48小时的超声心动图参数进行单因素统计学分析和Pearson相关性分析,选择单因素分析中有统计学显著差异的参数进行多因素logistic逐步回归分析。

结果

动脉导管未闭组的动脉导管分流速度以及降主动脉与肺动脉之间的压差(ΔPs)低于对照组(P < 0.05)。动脉导管未闭组的肺动脉压力(PASP)高于对照组(P < 0.05)。根据多因素logistic逐步回归分析,在首次超声心动图检查的48小时参数中,仅动脉导管最大分流速度与动脉导管早期自然闭合相关(P = 0.049)。受试者工作特征(ROC)曲线表明,出生后48小时早产儿超声心动图动脉导管分流速度的最佳临界点为1.165 m/s。

结论

超声心动图参数对预测早产儿动脉导管早期自然闭合具有重要价值。特别是,动脉导管分流速度与动脉导管早期自然闭合相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c0d4/10310433/139bffb377e7/fped-11-1198936-g001.jpg

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