支气管肺发育不良的肺血管发育与肺动脉高压的诊断和治疗相关问题  

Pulmonary vascular development,diagnosis and treatment for pulmonary hypertension in preterm in-fants with bronchopulmonary dysplasia

作　　者：施丽萍[1] 许燕萍[1] Shi Liping Xu Yanping(The Children＇s Hospital, School of Medicine , Zhejiang University , Han gzhou 310003, China)

机构地区：[1]浙江大学医学院附属儿童医院NICU,杭州310003

出　　处：《中国小儿急救医学》2016年第12期811-814,共4页Chinese Pediatric Emergency Medicine

摘　　要：肺动脉高压（ PH）是支气管肺发育不良（ BPD）的严重并发症，伴随着高病死率，肺血管发育的异常、肺血管的高反应性及结构的重建是导致PH的病理生理基础，本病临床症状隐匿，与本身肺部疾病难以鉴别，出现症状后诊断往往不可逆，建议具有高危因素的BPD患儿应常规进行筛查。心脏超声是无创、动态监测最常用的检查手段，对治疗效果不佳者行心导管或CT检查排除心血管异常，治疗包括急性阶段的综合治疗和降低肺动脉压力的药物选择，早期诊断、治疗将改善其预后。It is well known that pulmonary hypertension（PH） is one severe complication of bron-chopulmonary dysplasia（ BPD） that is associated with high mortality. Aberrant pulmonary vascular growth, abnormal vasoreactivity and pulmonary vascular remodeling may ultimately lead to PH. Symptoms of PH of-ten overlap those of BPD itself. Furthermore,the emergence of symptoms may indicate that the disease has already progressed to a late, less reversible phase, thereby supporting arguments for screening all infants at risk. Echocardiography is non-invasive and widely available,and is currently the most commonly used screen-ing modality for PH in infants with BPD. Because the incidence of associated cardiovascular anomalies is high,cardiac catheterization and CT scanning of the chest should be considered in all infants who have signifi-cant PH despite optimal management of their lung disease. Early diagnosis and aggressive specific drug thera-py can improve the outcome for these patients.

关 键 词：支气管肺发育不良 肺血管发育 诊断与治疗 肺动脉高压 早产儿 

分 类 号：R725.6[医药卫生—儿科]