Valdes-Cruz L M, Dudell G G, Ferrara A
Pediatrics. 1981 Oct;68(4):515-25.
The clinical syndrome of persistent pulmonary hypertension of the newborn (PPHN) still carries high mortality in spite of improved neonatal care. The purpose of this prospective study was to assess the utility of M-mode echocardiography for the early identification of infants with PPHN prior to clinical deterioration. Echocardiograms of 51 infants who needed fractional inspiratory oxygen (FIO2) greater than or equal to 0.25 to maintain adequate PaO2 within 36 hours of life were compared to those of 115 healthy full-term and preterm newborns. Of the 51 infants, ten had elevated systolic time interval ratios of both ventricles simultaneously (ventricular pre-ejection period to ventricular ejection time [RPEP/RVET greater than or equal to 0.50, LPEP/LVET greater than 0.38]). All of these newborns had PPHN that was manifest clinically by 11 to 30 hours of age. The echocardiographic findings preceded clinical deterioration by at least one to five hours in all cases. The other 41 infants had clinical courses consistent with uncomplicated pulmonary disease. These data indicate that systolic time interval ratios, although not accurate measures of pulmonary arterial pressure and/or pulmonary vascular resistance, permit early identification of infants with PPHN and separation from others with uncomplicated pulmonary disease.
尽管新生儿重症监护有所改善，但新生儿持续肺动脉高压（PPHN）的临床综合征死亡率仍然很高。这项前瞻性研究的目的是评估M型超声心动图在临床恶化前早期识别PPHN婴儿的效用。将51名在出生36小时内需吸入分数氧（FIO2）大于或等于0.25以维持足够动脉血氧分压（PaO2）的婴儿的超声心动图与115名健康足月儿和早产儿的超声心动图进行比较。在这51名婴儿中，有10名同时出现双心室收缩时间间期比值升高（心室射血前期与心室射血时间之比[RPEP/RVET大于或等于0.50，LPEP/LVET大于0.38]）。所有这些新生儿均患有PPHN，在11至30小时龄时出现临床症状。在所有病例中，超声心动图检查结果均比临床恶化提前至少1至5小时。其他41名婴儿的临床病程与无并发症的肺部疾病一致。这些数据表明，收缩时间间期比值虽然不是肺动脉压和/或肺血管阻力的精确测量指标，但可早期识别PPHN婴儿并将其与其他无并发症的肺部疾病婴儿区分开来。
