Pulmonary vascular resistance in repaired congenital diaphragmatic hernia vs. age-matched controls
Pulmonary vascular resistance in repaired congenital diaphragmatic hernia vs. age-matched controls
复制标题
修复先天性膈疝与年龄匹配对照的肺血管阻力
DOI：
10.1038/pr.2012.16
复制
发表时间：
2012
影响因子：
3.6
通讯作者：
Matthew E. Zussman
中科院分区：
文献类型：
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作者：
Matthew E. Zussman
前言：先天性隔膜疝修补术(CDH)的婴儿和儿童通常继续表现出生长发育迟缓，部分原因可能是不明原因的持续肺血管阻力(PVR)增加。方法：回顾2007-2010年间所有接受心导管术的6-36mo先天性隔膜疝修补术患者的数据，并与经皮动脉导管未闭(PDA)患者的对照人群的数据进行比较。检测指标肺血流量(QP)、平均肺动脉压(MPAP)、肺毛细血管楔压(PCWP)和肺静脉阻力。慢性阻塞性肺病患者平均动脉压(22.5±3.33vs.18.2±4.13 mm Hg)和室间隔阻力(3.66±0.79 vs 1.2 2±0.4IWU)均显著升高，而QP(4.0 8±1.43 vs 6.82±1.46 L/分/m2)明显降低。两组肺毛细血管楔压(PCWP)差异无统计学意义。不到一半的CDH患者在超声心动图上有肺动脉高压(PH)的征象。讨论：我们的数据表明，年龄在6-36个月的CDH修复者与对照组相比，PVR显著增加，早期考虑心导管术可能是必要的。
Introduction:Infants and children with repaired congenital diaphragmatic hernia (CDH) often continue to show delayed growth and development that may be, in part, secondary to unrecognized persistence of increased pulmonary vascular resistance (PVR).Methods:Data were reviewed from all patients ages 6–36 mo with repaired CDH who underwent cardiac catheterization from 2007 to 2010 and were compared to data from a control population of patients undergoing percutaneous closure of a patent ductus arteriosus (PDA). Indexed pulmonary blood flow (Qp), mean pulmonary artery pressure (mPAP), pulmonary capillary wedge pressure (PCWP), and PVR were examined.Results:Data from 8 CDH patients and 10 control patients were examined. The mPAP (22.5 ± 3.33 vs. 18.2 ± 4.13 mm Hg) and PVR (3.66 ± 0.79 vs. 1.22 ± 0.4 iwU (indexed Wood’s units)) were both significantly elevated in the CDH population, whereas the Qp (4.08 ± 1.43 vs. 6.82 ± 1.46 l/min/m2) was significantly lower in this population. There was no significant difference in pulmonary capillary wedge pressure (PCWP). Less than half of the CDH patients had signs of pulmonary hypertension (PH) on echocardiogram.Discussion:Our data suggest that children who are ages 6–36 mo with repaired CDH have significantly increased PVR compared with controls and early consideration of cardiac catheterization may be warranted.