超声血流参数对早产儿生后1周动脉导管自然关闭的预测价值

Predictive value of ultrasound blood flow parameters in early stage of preterm prematurecoronary artery closure

目的分析超声血流参数对早产儿动脉导管早期是否自然关闭的预测价值。方法选取2014年6月—2015年9月期间在我院出生后24小时内进行超声心动图检查动脉导管未闭的125例早产儿为研究对象,分别在生后第72小时和第7天对早产儿进行超声心动图检查。以出生后1周内超声心动图检查结果为依据将入选患者分为两组,出生后1周内动脉导管仍未关闭的25例早产儿为观察组(PDA组),出生后1周内动脉导管自然关闭的100例早产儿为对照组。在第一次超声检查中主要测量以下参数:卵圆孔分流速度、收缩期主动脉与肺动脉的压差、肺动脉收缩压。结果 (1)和对照组相比:观察组早产儿的降主动脉与肺动脉的压差以及卵圆孔分流速度明显降低(P<0.01,P<0.05),肺动脉收缩压明显升高(P<0.01);(2)利用收缩期主动脉与肺动脉的压差、卵圆孔分流速度和肺动脉收缩压预测出动脉导管早期自然关闭的最佳临界值为:19.68 mmHg、57.06 cm/s和33.73 mmHg。结论超声血流参数对预测早产儿动脉导管早期是否自然关闭而言具有重要意义。

Objective To analyze predictive value of ultrasound blood flow parameters in early stage of preterm premature coronary artery closure.Methods From June 2014 - 2015 year in September in our hospital during 24 hours after birth by echocardiography in 125 cases of premature infants with patent ductus closure as the research object,respectively in premature infants in seventy-second hours and seventh days by echocardiography.The patients were divided into two groups,the observation group （group PDA） of the preterm infants in the 1 weeks after the birth of the artery catheter is still closed,the control group of 100 cases of premature infants in the week after birth,the natural closure of the ductus arteriosus in 1 weeks.Based on the results of echocardiography,the comparison between groups was made.In the first ultrasound examination,the following parameters were measured：the velocity of the foramen ovale,the systolic pressure difference between the aorta and the pulmonary artery,the systolic pressure of pulmonary artery.Results （1） Compared with the control group：The pressure of the descending aorta and the pulmonary artery of preterm of the observation group and foramen shunt velocity were significantly decreased（P 〈 0.01,P 〈 0.05）,pulmonary artery systolic pressure was significantly increased （P 〈 0.01）;（2） Using the above monitoring parameters （pressure difference between the aorta and the pulmonary artery,the shunt velocity of the oval foramen and the pulmonary artery systolic pressure）,predicted the optimal critical value for the early spontaneous closure of the arterial catheter was：9.68 mmHg、57.06 cm/s and 33.73 mmHg.Conclusion Parameters of ultrasound blood flow are important to predict whether the early stage of preterm premature arterial catheter is naturally closed.