新生儿持续肺动脉高压病理机制及治疗进展  

Pathophysiology and treatment of persistent pulmonary hypertension of newborn infants

作　　者：陈小慧[1] 

机构地区：[1]南京医科大学附属南京妇幼保健院新生儿科,210004

出　　处：《中华实用儿科临床杂志》2014年第14期1041-1043,共3页Chinese Journal of Applied Clinical Pediatrics

摘　　要：新生儿持续肺动脉高压（PPHN）是新生儿时期的危重症,国外报道其发生率为2/1000～6/1000.目前对PPHN已有较多的研究,但其病因及病理机制仍不明了,PPHN的防治更是新生儿医师面临的重要挑战之一.肺血管的异常收缩、血管床发育不良、肺血管的重塑是PPHN的主要病理类型.治疗措施包括机械通气、镇静、肺表面活性物质替代治疗、血管活性物质、肺血管扩张剂等.目前吸入一氧化氮是扩张肺血管的主要措施.新的肺血管扩张药物如前列环素、内皮素-1抑制剂,磷脂酶抑制剂等已用于治疗难治性PPHN,但并未明显降低PPHN的病死率.Persistent pulmonary hvpertension of newborn（PPHN） is a life-threatening condition which occurs at a rate of 2/1 000-6/1 000.The etiology of PPHN is still unknown and its treatment remains a major challenge for neonatologist.Impaired pulmonary artery relaxation,reduced blood vessel density and pulmonary vascular remodeling are the main pathological changes in PPHN.The general managements include mechanical ventilation,sedation,surfactant and hemodynamic support.Inhaled nitric oxide is the main vasorelaxant used in the treatment of PPHN.Several other vasorelaxants have been studied such as phosphodiesterase inhibitors,prostacyclin,endothelin-1 inhibitors.Even with the introduction of several new therapeutic modalities there has been no significant change in survival rate.

关 键 词：新生儿肺动脉高压 病理机制 治疗 

分 类 号：R722.1[医药卫生—儿科]