Furzan J A, Reisch J, Tyson J E, Laird P, Rosenfeld C R
Early Hum Dev. 1985 Oct;12(1):39-48. doi: 10.1016/0378-3782(85)90135-5.
The incidence of symptomatic patent ductus arteriosus (sPDA) in very-low-birth-weight infants has been reported almost exclusively from referral centers. Moreover, the incidence has varied considerably. We prospectively evaluated the incidence and risk factors of sPDA in a totally inborn population of infants less than or equal to 1500 g birth weight (n = 120) receiving conservative fluid management and examined the role of echocardiography in predicting sPDA before clinical signs are evident. The incidence of sPDA was relatively low (16%) and the age at onset was relatively late (mean +/- S.E. = 14.7 +/- 3.0 days) when compared to prior reports. Echocardiographic changes preceded physical and radiographic findings of sPDA. Fluid volume within the range administered to our infants was unrelated to the occurrence of sPDA. However, risk factors identifiable within 24 h of birth were defined: obstetric estimate of gestational age, race, mean fluid volume intake in the initial 24 h, and early treatment with volume expanders. From these risk factors, 79% of infants with sPDA and 79% without sPDA could be predicted by stepwise discriminant function analyses. These findings may be employed in studies needed to assess the benefit of early surgical or pharmacologic therapy for infants at highest risk for sPDA.
极低出生体重儿有症状动脉导管未闭（sPDA）的发病率几乎仅来自转诊中心的报告。此外，发病率差异很大。我们前瞻性评估了出生体重小于或等于1500g的完全自产婴儿（n = 120）中sPDA的发病率和危险因素，这些婴儿接受保守的液体管理，并在临床症状出现之前检查了超声心动图在预测sPDA中的作用。与先前的报告相比，sPDA的发病率相对较低（16%），发病年龄相对较晚（平均±标准误= 14.7±3.0天）。sPDA的超声心动图改变先于其体格检查和影像学表现。给予我们婴儿的液体量范围与sPDA的发生无关。然而，确定了出生后24小时内可识别的危险因素：产科估计的孕周、种族、最初24小时的平均液体摄入量以及早期使用扩容剂治疗。通过逐步判别函数分析，可从这些危险因素中预测79%有sPDA的婴儿和79%无sPDA的婴儿。这些发现可用于评估早期手术或药物治疗对sPDA高危婴儿益处的研究中。
