早产儿动脉导管未闭超声参数预测早期自然关闭的价值

Evaluation of predicting the ductus arteriosus closure in preterm infants by echocardiography

目的探讨早产儿动脉导管未闭超声参数预测早期自然关闭的价值。方法对2013年10月至2014年10月在重庆市妇幼保健院出生的早产儿110例进行前瞻性研究,早产儿分别于1、3、7d行超声心动图检查,首次检查测量左心房收缩末期内径(LA)、主动脉根部内径(AO)及动脉导管相关参数分流束最细处宽度及导管最大分流速。出生后7d内动脉导管仍开放者为动脉导管未闭组;7d内动脉导管自然关闭者为对照组,并进行组间比较。结果 (1)早产儿动脉导管于3、7d内自然关闭率分别为70.9%(78/110)、78.2%(86/110);(2)动脉导管未闭组与对照组对比:LA/AO大于对照组(P<0.01);分流束最细处宽度大于对照组(P<0.01);最大分流速低于对照组(P<0.05);(3)动脉导管未闭早期自然关闭LA/AO、分流束导管最细处宽度及导管最大分流速的最佳临界点值分别为1.32mm、2.56mm及185.5cm/s。结论彩超对预测早产儿动脉导管未闭早期能否自然关闭具有重要意义。

Objective To investigate the values of echocardiographic parameters for predicting the spontaneous closure of the ductus arteriosus in preterm infants. Methods A retrospective study of 110 preterm infants from October 2013 to October 2014 in our hospital was done. Examination was done at 1,3,7 d with echocardiography for those infants. Diameter of left atrium（LA）,aotic root（AO） and arterial canal-related parameters （the smallest width of ductal color Doppler flow jet and the maximum velocity at the ductus） at first. Preterm infants in this study were divided into two groups. The early patent ductus arterisus group included ones whoes ductus didn＇t closed spontaneous in 7 d, and the control group included ones whoes ductus closed spontaneous in 7 d, and then the echocardiographic parameters between the two groups were compared. Results （1）The rates of ductus arteriosus spontaneous closure in preterm infants at 3,7 d were 70.9 % （78/110）, 78.2 % （86/110）,respectivly. （2）When compared with the control group,The rate of LA/AO in patent ductus arterisus group were higher than that of the control group（P〈0. 01） ;The smallest width of ductal color Doppler flow jet in patent ductus arterisus group were bigger than that of the control group（P〈0.01）;The maximum velocity at the ductus in patent ductus arterisus group were lower than that of the control group（P〈0.05）. （3）The best critical points of the LA/AO, the smallest width of ductal color Doppler flow jet and the maximum velocity at the ductus of the spontaneous ductus arteriosus closure in preterm infants were 1.32 mm,2.56 mm and 185.5 cm/s,respectivly. Conclusion Echo- cardiography plays a significant role in prediction of the spontaneous closure of the ductus arteriosus in preterm infants.