Subhedar N V, Hamdan A H, Ryan S W, Shaw N J
Department of Child Health, University of Liverpool.
Arch Dis Child Fetal Neonatal Ed. 1998 Jan;78(1):F20-4. doi: 10.1136/fn.78.1.f20.
To determine if pulmonary artery pressure (PAP) in ventilated preterm infants is independently associated with the development of chronic lung disease (CLD) and whether early assessment has any prognostic value.
Two cohorts (development n = 55; and validation n = 28) of preterm infants were studied at 24 hours of age. PAP was assessed non-invasively using its inverse correlation with the corrected acceleration time to right ventricular ejection time ratio (AT:RVET(c)), calculated from the pulmonary artery Doppler waveform. Clinical and respiratory variables were also collected. Using logistic regression analysis to identify factors independently associated with CLD, a prognostic score was developed to predict CLD. The ability of the score to predict CLD was described using receiver operating characteristic (ROC) curves.
Birthweight, inspired oxygen concentration, and AT:RVET(c) were independently predictive of CLD. The area under the ROC curve was 0.96 for the development and 0.89 for the validation cohort. Exclusion of AT:RVET(c) resulted in a reduction to 0.88 and 0.73, respectively.
PAP is independently associated with CLD. An early assessment of PAP using AT:RVET(c) may permit the early prediction of CLD as part of a multifactorial scoring system.
确定机械通气的早产儿肺动脉压（PAP）是否与慢性肺疾病（CLD）的发生独立相关，以及早期评估是否具有任何预后价值。
对两组早产儿队列（发育组n = 55；验证组n = 28）在出生24小时时进行研究。通过与根据肺动脉多普勒波形计算的右心室射血时间校正加速时间比（AT:RVET(c)）呈负相关，以非侵入性方式评估PAP。还收集了临床和呼吸变量。使用逻辑回归分析确定与CLD独立相关的因素，制定了一个预后评分来预测CLD。使用受试者工作特征（ROC）曲线描述该评分预测CLD的能力。
出生体重、吸入氧浓度和AT:RVET(c)是CLD的独立预测因素。发育组的ROC曲线下面积为0.96，验证组为0.89。排除AT:RVET(c)后，分别降至0.88和0.73。
PAP与CLD独立相关。使用AT:RVET(c)对PAP进行早期评估可能允许作为多因素评分系统的一部分对CLD进行早期预测。
