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首页> 外文期刊>Pediatrics: Official Publication of the American Academy of Pediatrics >Clinical utility of echocardiography for the diagnosis and management of pulmonary vascular disease in young children with chronic lung disease.
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Clinical utility of echocardiography for the diagnosis and management of pulmonary vascular disease in young children with chronic lung disease.

机译：超声心动图在慢性肺病幼儿诊断和管理肺血管疾病中的临床应用。

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OBJECTIVE: The goal was to determine the clinical utility of Doppler echocardiography in predicting the presence and severity of pulmonary hypertension in patients with chronic lung disease who subsequently underwent cardiac catheterization. METHODS: A retrospective review of data for all patients < 2 years of age with a diagnosis of bronchopulmonary dysplasia, congenital diaphragmatic hernia, or lung hypoplasia who underwent echocardiography and subsequently underwent cardiac catheterization for evaluation of pulmonary hypertension was performed. The accuracy of echocardiography in diagnosing pulmonary hypertension, on the basis of estimated systolic pulmonary artery pressure, was compared with the detection of pulmonary hypertension with the standard method of cardiac catheterization. RESULTS: Thirty-one linked measurements for 25 children were analyzed. Systolic pulmonary artery pressure could be estimated in 61% of studies, but there was poor correlation between echocardiography and cardiac catheterization measures of systolic pulmonary artery pressure in these infants. Compared with cardiac catheterization measurements, echocardiographic estimates of systolic pulmonary artery pressure diagnosed correctly the presence or absence of pulmonary hypertension in 79% of the studies in which systolic pulmonary artery pressure was estimated but determined the severity of pulmonary hypertension (severe pulmonary hypertension was defined as pulmonary/systemic pressure ratio of > or = 0.67) correctly in only 47% of those studies. Seven (58%) of 12 children without estimated systolic pulmonary artery pressure demonstrated pulmonary hypertension during subsequent cardiac catheterization. In the absence of estimated systolic pulmonary artery pressure, qualitative echocardiographic findings, either alone or in combination, had worse predictive value for the diagnosis of pulmonary hypertension. CONCLUSION: As used in clinical practice, echocardiography often identifies pulmonary hypertension in young children with chronic lung disease; however, estimates of systolic pulmonary artery pressure were not obtained consistently and were not reliable for determining the severity of pulmonary hypertension.
机译：目的：确定多普勒超声心动图在预测随后接受心脏导管检查的慢性肺病患者中肺动脉高压的存在和严重程度的临床实用性。方法：对所有<2岁且经超声心动图检查并随后行心脏导管检查以评估肺动脉高压的支气管肺发育异常，先天性diaphragm肌疝或肺发育不全的患者的数据进行回顾性回顾。将超声心动图在估计的收缩期肺动脉压的基础上，诊断肺动脉高压的准确性与采用标准心导管检查法检测肺动脉高压的准确性进行了比较。结果：对25名儿童的31项相关测量进行了分析。在61％的研究中可以估算出收缩期肺动脉压，但这些婴儿的超声心动图与心脏导管检查方法对收缩期肺动脉压的相关性较差。与心脏导管测量相比，在79％的研究中，超声心动图估计的收缩期肺动脉压正确诊断了肺动脉高压的存在或不存在，但确定了肺动脉高压的严重程度（严重肺动脉高压定义为在这些研究中，只有47％的患者的肺/体压比正确地大于或等于0.67）。在未估计收缩期肺动脉压的12名儿童中，有七名（58％）在随后的心脏导管插入过程中表现出肺动脉高压。在没有估计的收缩期肺动脉压的情况下，单独或联合使用的定性超声心动图检查结果对肺动脉高压的诊断具有较差的预测价值。结论：在临床实践中，超声心动图通常可识别出患有慢性肺病的幼儿的肺动脉高压。然而，不能始终如一地获得收缩期肺动脉压的估计值，并且不能确定肺动脉高压的严重程度。

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