Heymann M A, Hoffman J I
Paediatrician. 1978;7(1-3):3-17.
Postanatal closure of the ductus arteriosus depends on the level of O2 to which it is exposed. Certain vasoactive substances may also play a role in this constriction. The response to O2 is not as well developed in immature fetal animals and this probably explains the high incidence of patent ductus arteriosus (PDA) in premature human infants. The magnitude of shunting through a PDA depends on its size and the relationship between the pulmonary and systemic vascular resistances. Factors affecting the pulmonary vascular resistance (such as hypoxia) will therefore affect the shunt. The ability of the infant to handle the volume overload also depends on maturity of the infant since myocardial development may not be complete even at term. The clinical manifestations and management of PDA with and without pulmonary disease are described. Recent attempts at pharmacological closure of the PDA are presented.
出生后动脉导管的关闭取决于其所处的氧水平。某些血管活性物质可能也在这种收缩过程中发挥作用。未成熟的胎儿动物对氧的反应发育不完善，这可能解释了人类早产儿动脉导管未闭（PDA）的高发病率。通过PDA的分流程度取决于其大小以及肺血管阻力与体循环血管阻力之间的关系。因此，影响肺血管阻力的因素（如缺氧）会影响分流。婴儿处理容量超负荷的能力也取决于婴儿的成熟度，因为即使足月时心肌发育也可能不完全。本文描述了伴有和不伴有肺部疾病的PDA的临床表现及治疗。还介绍了近期在PDA药物封堵方面的尝试。
