预产期婴儿肺高血压的查:何时,有多频繁,有什么影响?
Samuel J Gentle1,2, Waldemar A Carlo3, Namasivayam Ambalavanan3
1Department of Pediatrics, The University of Alabama at Birmingham, Birmingham, Alabama, USA samuel.gentle@yale.edu.
Archives of disease in childhood. Fetal and neonatal edition
|September 5, 2025
概括
对肺高血压 (BPD-PH) 相关的支气管肺功能障碍 (BPD) 进行序列心声扫描可以改善检测,特别是在月经后36周后. 每月查提供了最高的负预测值来识别患有BPD-PH的婴儿.
科学领域:
- 新生儿医学
- 儿童心脏病学
- 呼吸系统医学
背景情况:
- 支气管肺功能障碍 (BPD) 相关的肺高血压 (BPD-PH) 是一种严重的BPD亚型.
- 在高危婴儿中,最佳的BPD-PH查策略仍未确定.
- 早期发现BPD-PH对于及时干预和改善结果至关重要.
研究的目的:
- 评估BPD-PH查系列心声扫描对婴儿的有效性
- 确定BPD-PH心声查的最佳时间和频率.
- 评估经过36周的月经后心声学 (PMA) 的负预测值.
主要方法:
- 一项单中心队列研究分析了394名婴儿的2542个心声图 (2017-2023年).
- 患有BPD-PH的婴儿之前的心声图被归类为虚假阴性;仅患有BPD的婴儿有真阴性.
- 对四种查策略进行了比较,以检测BPD-PH的能力.
主要成果:
- 从36周的PMA开始,每月进行心声查以达到最高的NPV.
- 根据查策略,BPD-PH的检测率有所不同:全面 (34.5%),早期 (20.0%),单一 (15.0%),晚期 (30.7%).
- 在PMA的36周及之后,心声查的诊断准确度有所提高.
结论:
- 序列心声扫描,特别是从36周PMA开始,提高了BPD-PH的检测.
- 在高风险的婴儿中,单个心声图不足以查BPD-PH.
- 在36周后每月查PMA似乎是识别BPD-PH的最有效策略.
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