CAJ | 학술논문

动脉导管未闭（PDA）在早产儿有较高发病率。临床症状和体征在早产儿PDA的诊断上缺乏特异性，超声心动图是目前诊断PDA特别是血流动力学改变显著的PDA（hsPDA）的重要手段。近期研究认为血清脑钠肽（BNP）和N-端脑钠肽原（NT-proBNP）可作为诊断hsPDA的生物标记物并指导早产儿PDA治疗策略的选择。早产儿PDA的治疗包括环氧酶（COX）抑制剂、吲哚美辛和布洛芬的药物疗法及外科结扎术。近期报道对乙酰氨基酚可作为对COX抑制剂不敏感或禁忌的早产儿治疗PDA的替代药物。经导管封堵在早产儿PDA的治疗上值得临床进一步研究。本文对早产儿PDA的诊疗进展作一综述。
동맥도관미폐（PDA）재조산인유교고발병솔。림상증상화체정재조산인PDA적진단상결핍특이성，초성심동도시목전진단PDA특별시혈류동역학개변현저적PDA（hsPDA）적중요수단。근기연구인위혈청뇌납태（BNP）화N-단뇌납태원（NT-proBNP）가작위진단hsPDA적생물표기물병지도조산인PDA치료책략적선택。조산인PDA적치료포괄배양매（COX）억제제、신타미신화포락분적약물요법급외과결찰술。근기보도대을선안기분가작위대COX억제제불민감혹금기적조산인치료PDA적체대약물。경도관봉도재조산인PDA적치료상치득림상진일보연구。본문대조산인PDA적진료진전작일종술。
Patent ductus arteriosus (PDA) is a common morbidity in premature infants. Clinical signs and symptoms of PDA in premature infants are not specific. Echocardiography is an important examination in the diagnosis of PDA, esp. those which are hemodynamically significant. Recent researches have demonstrated the validity of BNP and NT-proBNP as biomarkers for diagnosing PDA in preterm infants as well as guiding treatment selection. Classic treatment of PDA includes pharmacotherapy, namely cyclooxygenase (COX) inhibitors such as indomethacin and ibuprofen, and surgical ligation. It is lately reported that paracetamol could be a drug of choice in COX inhibitor-insensitive or contraindicated patients, while transcatheter occlusion is worthy of further study. This paper reviewed the progress in diagnoses and management of PDA in premature infants.