早产儿动脉导管未闭发病机制研究进展

Progress in pathogenesis of patent ductus arteriosus in preterm infants

动脉导管未闭（PDA）是早产儿常见的并发症之一，可导致或加重呼吸窘迫、慢性肺疾病、颅内出血和坏死性小肠结肠炎的发生发展，也是影响早产儿存活率和后遗症发生率的主要原因之一。近年研究发现，早产儿PDA的发生除与自身动脉导管的组织发育不成熟、不易发生重塑有关外，还与动脉导管对氧、血管活性物质的反应异常有关；遗传因素也参与早产儿PDA的发病。国外已经有学者提出血小板诱导或驱使动脉导管关闭的新观点。

Patent ductus arteriosus is one of the common complications in the premature infants,which lead to or worsen respiratory distress, chronic pulmonary disease,intraventricular hemorrhage and necrotizing enterocolitis. It is associated with an increase in mortality and sequelae of preterm infants. The various factors contributing to an patency of the ductus arteriosus in the preterm infants are involved in：insufficient histological development of ductus arteriosus, failure of remodeling the ductus,abnormal sensitivity of the ductus to oxygen and vasoactive substances, and genes. It has been proposed a new idea that platelet induces or drives the closure of patent ductus arteriosus.