超声心动图评价新生儿动脉导管闭合前后肺动脉压力的变化

Echocardiographic evaluation of the changes of neonatal pulmonary arterial pressure before and after ductus arteriosus closure

目的应用超声心动图评价新生儿动脉导管闭合前后肺动脉压力的变化。方法选取经超声心动图确诊存在动脉导管未闭的新生儿41例,应用三尖瓣反流法评估其肺动脉收缩压,于服用布洛芬混悬液治疗3~7 d后复查超声心动图,观察动脉导管是否闭合,以及肺动脉收缩压、右房室腔大小、肺动脉主干内径的变化,分析肺动脉压力与动脉导管内径的相关性。结果 41例动脉导管未闭患儿,30例于治疗3 d后闭合,6例于治疗7 d后闭合,2例未闭合,3例死亡。36例经治疗后动脉导管闭合的新生儿,其动脉导管闭合后肺动脉收缩压较治疗前明显下降,右房室腔大小和肺动脉主干内径较治疗前明显缩小,差异均有统计学意义(均P<0.05)。41例患儿肺动脉压力与动脉导管内径呈正相关(r=0.77,P<0.01)。结论超声心动图在评价新生儿动脉导管闭合前后肺动脉压力的变化情况方面具有重要作用。

Objective To explore the changes of neonatal pulmonary arterial pressure before and after ductus arteriosus closure. Methods Forty-one cases of newborns with patent ductus arteriosus confirmed by echocardiography were collected.Tricuspid regurgitation methods were used to assess pulmonary artery systolic pressure. After 3 ~7 d treatment of ibuprofen suspension liquid,echocardiography were reexamined to observe whether ductus arteriosus was closed,and to observe the changes in the pulmonary artery systolic pressure,the right atrioventricular cavity size and the pulmonary artery trunk diameter. Correlation between pulmonary artery pressure and ductus arteriosus diameter were also analyzed. Results Forty-one cases of neonatal with patent ductus arteriosus were detected. Among them,3 cases died,30 cases ductus arteriosus closed after 3 d treatment,6 cases ductus arteriosus closed after 7 d,and 2 cases ductus arteriosus were remained open. After treatment,the pulmonary artery systolic pressure of 36 cases of patent ductus arteriosus significantly decreased than that before treatment,the size of right atrioventricular cavity and the diameter of pulmonary artery trunk significantly decreased than before treatment,the differences were statistically significant（all P〈0.05）. Pulmonary artery pressure of 41 newborns with patent ductus arteriosus was positively correlated with the diameter of the ductus arteriosus（r=0.77,P〈0.01）. Conclusion Echocardiography in evaluating the change of neonatal pulmonary arterial pressure before and after ductus arteriosus closure has a unique advantage.