Roberson D A, Silverman N H
Department of Pediatrics, University of California, San Francisco.
Pediatr Cardiol. 1994 Sep-Oct;15(5):219-24. doi: 10.1007/BF00795730.
Forty-eight preterm infants (mean birthweight 1.0 +/- 0.3 kg; mean gestational age 28 +/- 3 weeks) underwent serial echocardiograms and physical examinations in order to determine the correlation between color Doppler flow mapping (CDFM) results and physical findings of a patent ductus arteriosus (PDA), the predictive value of early CDFM as an indicator of subsequent requirement for treatment of a PDA, and to determine the direction and duration of ductal shunting and the rate of ductal closure and opening. CDFM analysis and cardiac physical examination of left-to-right ductal shunting were usually concordant in infants with a large PDA shunt, the most reliable physical finding being increased precordial activity. CDFM studies on day 2 or 3 of postnatal life had prognostic value with regard to subsequent need for closing the PDA. Additional findings included the absence of right-to-left PDA shunting in infants < 1 kg and < 28 weeks gestation and the absence of ductal reopening in infants in whom it had closed spontaneously. After complete PDA closure using indomethacin, subsequent ductal reopening is uncommon, except in infants < 25 weeks gestation and < 700 g bodyweight.
48名早产儿（平均出生体重1.0±0.3kg；平均胎龄28±3周）接受了系列超声心动图检查和体格检查，以确定彩色多普勒血流显像（CDFM）结果与动脉导管未闭（PDA）体格检查结果之间的相关性、早期CDFM作为PDA后续治疗需求指标的预测价值，并确定导管分流的方向和持续时间以及导管闭合和开放的速率。对于存在大量PDA分流的婴儿，CDFM分析和左向右导管分流的心脏体格检查结果通常一致，最可靠的体格检查发现是心前区活动增强。出生后第2天或第3天的CDFM研究对于PDA后续闭合需求具有预后价值。其他发现包括体重<1kg且胎龄<28周的婴儿不存在右向左PDA分流，以及已自行闭合的婴儿不存在导管重新开放。使用吲哚美辛使PDA完全闭合后，除胎龄<25周且体重<700g的婴儿外），后续导管重新开放并不常见。
