Clinical Investigation on Patent Ductus Arteriosus of Premature Infants / 实用儿科临床杂志

ABSTRACT

Objective To investigate the incidence rate, high risk factors and hemodynamic changes of patent ductus arteriosus (PDA) in premature infants, and to give suggestions abo ut clinical monitoring and management of PDA in premature infants. Methods Echocardiography was performed on 86 non-ventilated or weaned from ventilator-pr emature infants at 2 to 5 days of age,whose gestational age was 28 to 36 weeks. All premature infants diagnosed as PDA were followed up clinically and by Echoc ardiography until discharged. Results Twenty-two infants diagnosed as PDA at mean 3 days of age, mean gestational age was (33.l?2.0) weeks. Ductus in 16 infants (out of 20 infants) closed spontaneo usly when repeated echocardiography at mean 8.5 days of age. For 4 remaining PDA infants, ductus closed in 2 cases (l treated with indomethacin). One ductus reo pened because of sepsis, and 3 infants discharged with opened ductus at their 2l , 40 and 47 days of age respectively. Single and multiple Logistic analysis indi cated that the lower the birth-weight ,the higher the incidence of PDA (?2=2. 8907 P=0.0891); neonatal asphyxia and suffered from severe diseases (neonat al respiratory distress syndrome, sepsis) were high risk factors of PDA (?2= 4.3729 P=0.0365;?2=11.6590 P=0.0006). Premature infants with PDA h ad good heart function,although their LA/AO ratio increased slightly (1.0810?0. 18 vs 1.00?0.07,P= 0.048).Conclusions PDA incidence at 3 days of life in 33 weeks premature infants is 25.6%, 85% PDA disappeares spontaneously during follow-up. Low birth-weight asphyxia, severe diseases and symptomatic PDA are high risk factors of PDA. Ductus can reopen in premature infants. J Appl Clin Pediatr,2005,20(2)129-131