胸阻抗法无创血流动力学监测联合B型钠尿肽对早产儿有血流动力学意义的动脉导管未闭的预测价值  

Predictive value of thoracic impedance non-invasive hemodynamic monitoring combined with brain natriuretic peptide for premature infants with hemodynamically significant patent ductus arteriosus

作　　者：韩玉杰 张会平[1] 陈晓[1] 孙明英 刘向红[1] 康丽丽[1] 李晓莺[1] HAN Yujie;ZHANG Huiping;CHEN Xiao;SUN Mingying;LIU Xianghong;KANG Lili;LI Xiaoying(Department of Neonatology,Children’s Hospital Affiliated to Shandong University,Jinan Children’s Hospital,Shandong Province,Jinan 252000,China)

机构地区：[1]山东大学附属儿童医院济南市儿童医院新生儿科,山东济南252000

出　　处：《妇儿健康导刊》2023年第16期7-10,14,F0003,共6页JOURNAL OF WOMEN AND CHILDREN'S HEALTH GUIDE

基　　金：山东省济南市卫生健康委员会科技计划项目(2022-1-48)。

摘　　要：目的探讨胸阻抗法无创血流动力学监测联合B型钠尿肽(BNP)对早产儿有血流动力学意义的动脉导管未闭(hsPDA)的预测价值。方法选取2022年3月至2023年3月山东大学附属儿童医院收治的66例动脉导管未闭(PDA)早产儿作为研究对象,根据PDA早产儿是否为hsPDA分为hsPDA组(32例)和非hsPDA组(34例)。使用胸阻抗法无创心排量监测仪(ICON®)监测两组早产儿血流动力学参数,同时进行超声心动图及实验室检查(血常规、C反应蛋白、心肌酶、BNP等),比较两组之间各指标的差异。结果hsPDA组患儿BNP水平高于非hsPDA组,无创血流动力学监测中的心指数(CI)、心输出量(CO)高于非hsPDA组,差异均有统计学意义(P<0.05)。在早期预测hsPDA时,胸阻抗法无创血流动力学监测的CO、CI联合BNP表现出较高的敏感度和特异性。结论胸阻抗法无创血流动力学监测可作为早产儿hsPDA有效预测心功能的工具。通过对CI、CO、BNP等的监测,能够及早发现和干预PDA早产儿的心功能异常,帮助其改善临床结局。Objective To explore the predictive value of thoracic impedance non-invasive hemodynamic monitoring combined with brain natriuretic peptide(BNP)for premature infants with hemodynamically significant patent ductus arteriosus(hsPDA).Methods A total of 66 premature infants with patent ductus arteriosus(PDA)in Children’s Hospital Affiliated to Shandong Univers ity from March 2022 to March 2023 were s elected and divided into hs PDA group(32 cases)and non-hsPDA group(34 cases)according to whether the PDA preterm infants were hsPDA or not.The hemodynamic parameters of premature infants in the two groups were monitored using thoracic impedance non-invasive cardiac displacement(ICON®),and the echocardiography and laboratory tests(blood routine examination,C-reactive protein,myocardial enzyme,BNP,etc.)were conducted at the same time.The differences of each index between the two groups were compared.Results The level of BNP,cardiac index(CI)and cardiac output(CO)in the hsPDA group were higher than those in the non-hsPDA group,and the differences were statistically significant(P<0.05).The CI and CO monitored by thoracic im pedance non-invasive cardiography combined with BNP showed high sensitivity and specificity in the early hsPDA prediction.Conclusion Thoracic impedance non-invasive hemodynamic monitoring can be used as an effective tool to predict cardiac function in premature infants with hsPDA.Monitoring CO,CI and BNP allows timely identification and management of cardiac dysfunction in prematu re infants with PDA and improves clinical outcomes.

关 键 词：胸阻抗法 有血流动力学意义的动脉导管未闭 无创心排 B型钠尿肽 

分 类 号：R722.6[医药卫生—儿科]