高频超声预测早产儿动脉导管早期自然关闭的价值  

The value of high frequency ultrasound in predicting spontaneous closure of patent ductus arteriosus in preterm neonates

作　　者：余瑕[1] 林仙方[2] 刘志聪[1] 蔡洁[1] 

机构地区：[1]浙江省金华市人民医院超声科,321000 [2]浙江省台州医院超声科

出　　处：《中华医学超声杂志（电子版）》2014年第3期18-21,共4页Chinese Journal of Medical Ultrasound(Electronic Edition)

摘　　要：目的探讨高频超声预测早产儿动脉导管早期自然关闭的价值。方法 170名早产儿(孕周<37周),均在出生后24 h内入院,高频及常规超声心动图连续观察动脉导管,首次超声心动图检查于出生后24 h内完成,以后每天随访观察至第7天,若此期间发现动脉导管已经闭合,则不再继续随访检查。其中16名早产儿动脉导管出生7 d内未自然关闭,为动脉导管早期未自然关闭(早期PDA)组,另从7 d内自然关闭组中随机选取32名早产儿作为对照组,分别采用高频探头及常规心脏探头测量动脉导管内径、左房前后径与主动脉根部内径比值(LA/AO)。结果早产儿动脉导管于24、48、72 h内自然关闭率分别约18.8%(32/170)、61.2%(104/170)、78.8%(134/170),7 d内达90.6%(154/170),即早产儿出生后早期动脉导管自然关闭率约90.6%(154/170)。高频超声对动脉导管二维及彩色血流长度完整显示率均高于常规超声[82%(39/48)vs 46%(22/48),P<0.001,100%(48/48)vs 77.1%(37/48),P<0.01],差异有统计学意义。高频超声测得早期PDA组动脉导管的内径大于对照组[(2.08±0.4)mm vs(1.09±0.22)mm,P<0.001],以1.55 mm为临界值,预测早生儿出生后7 d内动脉导管自然关闭的敏感度、特异度分别为87.5%、90.6%,准确性为66.5%。结论高频超声能明确诊断早产儿PDA,在精确显示动脉导管结构上优于常规超声心动图;动脉导管内径越大,早期自然关闭可能性越小。Objective To study the value of high frequency ultrasound in predicting spontaneous closure of patent duct arteriosus （PDA） in premature neonates. Methods One hundred and seventy premature neonates aged less than 37 weeks of gestation were enrolled. They were all admitted in the neonatal intensive care unit of Jinhua People＇ s Hospital within 24 hours after birth. Echocardiographic examinations was conducted using GE＇ s Vivid I Portable color Doppler ultrasonography with routine cardiac probe （frequency 1.7-3.4 MHz） and high-frequency transducer （frequency 7.5 MHz）. Up to the 7th day, the echocardiography was carried out every day after birth until the closure of PDA .They were divided to two groups according to whether spontaneous closure of PDA took place with in 7 days after birth （the control group） or not （the PDA group）. There were 16 premature neonates in PDA group, including 6 male and 10 female. The mean gestational week at birth was （35.3 4±1.4） weeks. The mean birth weight was （2 330.9 4±325.5） g. Thirty-two premature neonates were included incontrol group, including 13 male and 19 female. The mean gestational week at birth was （35.0±1.3） weeks. The mean birth weight was （2 337.54±287.8） g. The clinical characteristics and echocardiographic parameters were compared between the two groups. Results The detection rates of high-frequency ultrasound and routine echocardiography were all 100%. The spontaneous closure rate of PDA in preterm infants at 24 hours, 48 hours, 72 hours were 18.8% （32/170）, 61.2% （104/170）, 78.8% （134/170） respectively. Within 7 days after birth, the closure rate was 90.6% （154/170）, therefore the incidence of PDA in premature neonates was about 9.4% （16/170） in our study. The display rate of entire duct arteriosus using high frequency ultrasound was significantly higher than that using routine ultrasound [82%（39/48） vs 46%（22/48）, P 〈 0.001, 100%（48/48） vs 77.1%（37/48）, P 〈 0.01]. The diameters of d

关 键 词：超声检查 婴儿 早产 动脉导管未闭 超声心动描记术 

分 类 号：R445.1[医药卫生—影像医学与核医学] R722.6[医药卫生—诊断学]