新生儿持续性肺动脉高压诊治进展
临床表现,病因,治疗
牟杰 包蕾【摘要】 新生儿持续肺动脉高压(PPHN)是指出生后,因各种病因导致肺血管阻力持续增加引起肺动脉压高于体循环压,右心腔静脉血流通过卵圆孔和/或动脉导管产生大量的右向左分流,是多种因素所致的临床综合征。母亲吸烟,胎儿宫内生长受限、双胎输血综合征及部分遗传基因位点是PPHN的潜在高危因素。超声心动图是诊断新生儿肺动脉高压的金标准,超敏肌钙蛋白T、血管内皮生长因子、白细胞介素-17及转化生长因子-β1能间接反映PPHN的严重程度,为其诊断提供新的手段。在治疗方面,重组人超氧化物歧化酶(SOD)、sGC激活剂、类固醇激素、四氢生物蝶呤(BH4)及其前体,对PPHN的病理生理模型均有改善作用,为笔者下一步研究提供新的方向。
【关键词】 新生儿肺动脉高压 病因 临床表现 诊断 治疗
[Abstract] Neonatal persistent pulmonary hypertension (PPHN) refers to the clinical syndrome caused by multiple factors after birth, when pulmonary vascular resistance increases continuously due to various causes, causing pulmonary arterial pressure to be higher than systemic circulation pressure, and the right cardiac vena cava blood flows through the egg foramen and/or arterial catheter, producing a large number of right-to-left shunt. Maternal smoking, fetal intrauterine growth restriction, twin transfusion syndrome and some genetic loci are potential risk factors for PPHN. Supersonic and enchanted the graph is the gold standard in the diagnosis of neonatal pulmonary hypertension, hs-cTnT, IL-17, VEGF and TGF-β1 can indirectly reflect the severity of the PPHN ......
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