Increased incidence of idiopathic persistent pulmonary hypertension in Down syndrome neonates
Increased incidence of idiopathic persistent pulmonary hypertension in Down syndrome neonates
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DOI：
10.1007/s00246-006-0011-6
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发表时间：
2007-08-01
影响因子：
1.6
通讯作者：
Nelin, L. D.
中科院分区：
文献类型：
--
作者：
Cua, C. L.;Blankenship, A.;Nelin, L. D.
与年龄匹配的对照组相比，唐氏综合征（DS）患者在以后的生活中发生肺动脉高压的风险增加。本研究的目的是确定新生儿DS患者中新生儿持续性肺动脉高压（PPHN）的发生率是否也高于一般人群。对新生儿重症监护室3年期间收治的DS患者进行了回顾性病历审查。排除胎粪吸入综合征、肺部感染或肺部占位性病变的DS患者。DS患者根据治疗分为四组，包括无干预（A）、补充氧气（B）、机械通气（C）和吸入一氧化氮（D）。D组为PPHN。采用样本与已知总体差异的z检验、卡方检验、t检验以及Tukey调整事后检验的方差分析进行分析。p < 0.05被认为是显著的。共有58例患者符合入选标准。A组24例DS患者，B组17例，C组10例，D组7例。四组之间的性别（男性：分别为10、5、5和5）、胎龄（分别为36.4、38.2、36.4和36.4周）、体重（分别为2.8、3.0、2.4和3.0 kg）或先天性心脏病（分别为17、10、6和1）无差异。在此期间，估计在俄亥俄州出生的DS患者数量为598例;因此，DS中PPHN的发生率为1.2%。PPHN的报告发病率为0.1%。报告的PPHN发生率显著低于DS中的PPHN发生率（z = 2.7，p = 0.007）。得出的结论是，与历史对照相比，DS患者的PPHN发生率增加，无论基线人口统计学如何。
Down syndrome (DS) patients have an increased risk of developing pulmonary hypertension later in life compared to age-matched controls. The goal of this study was to determine if the incidence of persistent pulmonary hypertension of the newborn (PPHN) is also higher in neonatal DS patients compared to the general population. A retrospective chart review of DS patients admitted during a 3-year period to the neonatal intensive care unit was performed. DS patients with meconium aspiration syndrome, pulmonary infections, or pulmonary space-occupying lesions were excluded. DS patients were divided into four groups based on treatment and consisted of no intervention (A), supplemental oxygen (B,) mechanical ventilation use (C), and inhaled nitric oxide administration (D). Group D was defined as having PPHN. z test of the difference between sample and known population, chi-square, t-test, and analysis of variance with Tukey adjusted post hoc test were used for analysis. p < 0.05 was considered significant. A total of 58 patients met inclusion criteria. Twenty-four DS patients were in group A, 17 in group B, 10 in group C, and 7 in group D. There was no difference between the four groups for gender (males: 10, 5, 5, and 5, respectively), gestational age (36.4, 38.2, 36.4, and 36.4 weeks, respectively), weight (2.8, 3.0, 2.4, and 3.0 kg, respectively), or the presence of congenital heart defects (17, 10, 6, and 1, respectively). The estimated number of DS patients born in the state of Ohio during this period was 598; therefore, the incidence of PPHN in DS was 1.2%. The reported incidence of PPHN is 0.1%. The Reported incidence of PPHN was significantly lower versus the incidence of PPHN in DS (z = 2.7, p = 0.007). It was concluded that DS patients have an increased incidence of PPHN compared to historical controls regardless of baseline demographics.