早产儿动脉导管未闭对肠道组织血氧饱和度、血流动力学指标的影响及关联度分析  

Effect of patent ductus arteriosus on intestinal tissue oxygen saturation and hemodynamic indexes in premature infants and their correlation analysis

作　　者：康迁 何永 邓斌[2] 尹琳琳 KANG Qian;HE Yong;DENG Bin;YIN Linlin(North Sichuan Medical College,Nanchong,Sichuan,China,637000;Department of Pediatrics,North Sichuan Medical College Affiliated Hospital,Nanchong,Sichuan,China,637000)

机构地区：[1]川北医学院,四川南充637000 [2]川北医学院附属医院儿科,四川南充637000

出　　处：《分子诊断与治疗杂志》2025年第2期271-274,共4页Journal of Molecular Diagnostics and Therapy

基　　金：川北医学院校级科研发展基金项目(CBY22-QNA40)。

摘　　要：目的本研究目的在于分析有血流动力学意义的动脉导管未闭(hsPDA)与无血流动力学意义的动脉导管未闭(nhsPDA)的早产儿间肠道组织血氧饱和度和血流动力学指标的差异,及这些指标间的相关性。方法选取2023年1月至2024年6月在川北医学院附属医院收治的81例动脉导管未闭(PDA)早产儿为研究对象,根据hsPDA的诊断标准分为hsPDA组(n=14)和nhsPDA组(n=68)。通过近红外光谱监测仪测量各组肠道血氧饱和度,采用多普勒超声检测血流动力学指标。通过Spearman相关性分析探讨肠道血氧饱和度与血流动力学指标之间的关联性,通过ROC曲线评估其预测价值。结果hsPDA组患儿诊断后6 h、12 h、24 h的rSO2值均低于nhsPDA组差异有统计学意义(P<0.05)。hsPDA组患儿动脉导管直径、LA/AO、LVESD均高于nhsPDA组,LVEF、FS均低于nhsPDA组差异有统计学意义(P<0.05)。采用Pearson相关性分析,rSO2与LVEF、FS存在正相关(P<0.05),与动脉导管直径、LA/AO存在负相关(P<0.05)。ROC曲线分析显示,结合肠道血氧饱和度与血流动力学指标对早产儿发生hsPDA的预测具有较高的诊断准确性,AUC值为0.971,灵敏度为92.9%,特异度为97.1%。结论hsPDA与nhsPDA早产儿在肠道血氧饱和度及血流动力学指标方面差异显著,且两者相关性对hsPDA的预测效能较高。Objective To investigate the differences in intestinal tissue oxygen saturation and hemodynamic indicators between premature infants with hemodynamically significant patent ductus arteriosus(hsPDA)and those with non-hemodynamically significant patent ductus arteriosus(nhsPDA),and to analyze the correlations between these indicators.Methods A total of 81 premature infants diagnosed with patent ductus arteriosus(PDA)were treated at the affiliated hospital of North Sichuan Medical College from January 2023 to June 2024.They were divided into the hsPDA(n=14)and nhsPDA(n=68)groups based on the diagnostic criteria for hsPDA.Intestinal tissue oxygen saturation was measured using near-infrared spectroscopy,and hemodynamic indicators were assessed with Doppler ultrasound.The associations between intestinal oxygen saturation and hemodynamic indicators were examined using Spearman's correlation analysis,and their predictive value was evaluated through ROC curve analysis.Results The rSO2 values in the hsPDA group were lower than those in the nhsPDA group at 6 hours,12 hours,and 24 hours post-diagnosis(P<0.05).The arterial duct diameter,LA/AO,and LVESD were higher,while LVEF and FS were lower in the hsPDA group compared to the nhsPDA group(P<0.05).Pearson correlation analysis showed a positive correlation between rSO2 and LVEF,FS(P<0.05),and a negative correlation with arterial duct diameter and LA/AO(P<0.05).ROC curve analysis indicated that combining intestinal oxygen saturation with hemodynamic indicators provided high diagnostic accuracy for predicting hsPDA in premature infants,with an AUC of 0.971,sensitivity of 92.9%,and specificity of 97.1%.Conclusion Significant differences in intestinal oxygen saturation and hemodynamic parameters are observed between hsPDA and nhsPDA preterm infants.The correlation between these differences is found to have high predictive efficiency for hsPDA.

关 键 词：早产儿 动脉导管未闭 肠道血氧饱和度 血流动力学 

分 类 号：R72[医药卫生—儿科]