Characteristics of Patent Ductus Arteriosus in Congenital Rubella Syndrome
Characteristics of Patent Ductus Arteriosus in Congenital Rubella Syndrome
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DOI：
10.1038/s41598-019-52936-6
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发表时间：
2019-11-19
影响因子：
4.6
通讯作者：
Yoshida, Lay-Myint
中科院分区：
文献类型：
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作者：
Toizumi, Michiko;Do, Cam Giang T.;Yoshida, Lay-Myint
本研究探讨了先天性风疹综合征（CRS）相关心脏并发症，特别是动脉导管未闭（PDA）的特点。我们回顾了2010年12月至2012年12月期间在越南第一儿童医院住院的CRS患者的病历，以及2009年12月至2015年12月期间在心脏科接受PDA经导管封堵治疗的CRS患者的病历。我们比较了2014年7月至2015年12月期间接受PDA经导管封堵术的CRS儿童（CRS-PDA）和无CRS儿童（非CRS-PDA）的PDA经导管封堵术特征。108名CRS儿童入组。心脏缺陷（99%），白内障（72%）和听力障碍（7%）被发现。对50例CRS-PDA和290例非CRS-PDA患者进行了检查。与非CRS-PDA患者相比，CRS-PDA患者的中位出生体重更小（p <0.001），肺动脉和主动脉狭窄更频繁（p <0.001），主肺动脉压更高，收缩期/舒张期主动脉压更高（均p < 0.001）。CRS-PDA患者中管状型PDA的比例（16%）高于非CRS-PDA患者（3%）（p = 0.020）。导管型PDA多见于CRS患者，并伴有肺/体动脉高压和肺/主动脉瓣狭窄;在这些患者中，需要更谨慎地选择经导管PDA封堵器。
This study investigated the characteristics of congenital rubella syndrome (CRS)-associated cardiac complications, particularly patent ductus arteriosus (PDA). We reviewed the medical records of patients with CRS who were admitted to the Children's Hospital 1 in Vietnam between December 2010 and December 2012, and patients with CRS who underwent PDA transcatheter occlusion therapy at the cardiology department between December 2009 and December 2015. We compared the characteristics of PDA treated with transcatheter closure between children with CRS (CRS-PDA) and those without CRS (non-CRS-PDA) who underwent PDA transcatheter closure between July 2014 and December 2015. One-hundred-and-eight children with CRS were enrolled. Cardiac defects (99%), cataracts (72%), and hearing impairment (7%) were detected. Fifty CRS-PDA and 290 non-CRS-PDA patients were examined. CRS-PDA patients had smaller median birthweight (p < 0.001), more frequent pulmonary (p < 0.001) and aortic stenosis (p < 0.001), higher main pulmonary artery pressure, and higher aortic pressure in systole/diastole (p < 0.001 for each) than did non-CRS-PDA patients. The proportion of tubular-type PDA was higher in CRS-PDA patients (16%) than in non-CRS-PDA patients (3%) (p = 0.020). Tubular-type PDA was frequently seen in patients with CRS and accompanied by pulmonary/systemic hypertension and pulmonary/aortic stenosis; in these patients, more cautious device selection is needed for transcatheter PDA closure.