[ 摘要 ] 目的 探讨胸阻抗法无创血流动力学监测联合 B 型钠尿肽（BNP）对早产儿有血流动力学意义的动脉 导管未闭（hsPDA）的预测价值。 方法 选取 2022 年 3 月至 2023 年 3 月山东大学附属儿童医院收治的 66 例动 脉导管未闭（PDA）早产儿作为研究对象，根据 PDA 早产儿是否为 hsPDA 分为 hsPDA 组（32 例）和非 hsPDA 组（34 例）。使用胸阻抗法无创心排量监测仪（ICON?）监测两组早产儿血流动力学参数，同时进行超声心动 图及实验室检查（血常规、C 反应蛋白、心肌酶、BNP 等），比较两组之间各指标的差异。 结果 hsPDA 组患儿 BNP 水平高于非 hsPDA 组，无创血流动力学监测中的心指数（CI）、心输出量（CO）高于非 hsPDA 组，差异均 有统计学意义（P < 0.05）。在早期预测 hsPDA 时，胸阻抗法无创血流动力学监测的 CO、CI 联合 BNP 表现出 较高的敏感度和特异性。 结论 胸阻抗法无创血流动力学监测可作为早产儿 hsPDA 有效预测心功能的工具。 通过对 CI、CO、BNP 等的监测，能够及早发现和干预 PDA 早产儿的心功能异常，帮助其改善临床结局。

[Abstract] Objective To explore the predictive value of thoracic impedance non-invasive hemodynamic monitoring combined with brain natriuretic peptide (BNP) for premature infants with hemodynamically significant patent ductus arteriosus (hsPDA). Methods A total of 66 premature infants with patent ductus arteriosus (PDA) in Children’s Hospital Affiliated to Shandong University from March 2022 to March 2023 were selected and divided into hsPDA group (32 cases) and non-hsPDA group (34 cases) according to whether the PDA preterm infants were hsPDA or not. The hemodynamic parameters of premature infants in the two groups were monitored using thoracic impedance non-invasive cardiac displacement (ICON?), and the echocardiography and laboratory tests (blood routine examination, C-reactive protein, myocardial enzyme, BNP, etc.) were conducted at the same time. The differences of each index between the two groups were compared. Results The level of BNP, cardiac index (CI) and cardiac output (CO) in the hsPDA group were higher than those in the non-hsPDA group, and the differences were statistically significant (P < 0.05). The CI and CO monitored by thoracic impedance non-invasive cardiography combined with BNP showed high sensitivity and specificity in the early hsPDA prediction. Conclusion Thoracic impedance non-invasive hemodynamic monitoring can be used as an effective tool to predict cardiac function in premature infants with hsPDA. Monitoring CO, CI and BNP allows timely identification and management of cardiac dysfunction in premature infants with PDA and improves clinical outcomes.

R722.6

[ 基金项目 ] 山东省济南市卫生健康委员会科技计划项目 （2022-1-48）。