男性患儿，生后1 d，因持续性肺动脉高压入院，经积极治疗后肺动脉高压仍进行性加重，且早期出现右心衰竭。家系全外显子组测序提示患儿存在NDUFAF2基因复合杂合变异c.192del和c.192_193del，分别遗传自父母，符合美国医学遗传学与基因组学学会的致病性变异标准。尸检结果提示肺动脉扩张及心肌肥厚，肺组织电镜检查未见肺泡毛细血管发育不良。NDUFAF2基因突变与线粒体复合体Ⅰ缺乏症相关，该病例首次将其与新生儿原发性肺动脉高压关联，为原发性肺动脉高压的遗传病因提供新证据，并强调遗传学及病理学在新生儿重症疾病研究中的重要性。

A male neonate was admitted on postnatal day 1 with persistent pulmonary hypertension. Despite aggressive treatment, the pulmonary hypertension progressively worsened, leading to early right heart failure. Whole-exome sequencing of the family revealed compound heterozygous mutations c.192del and c.192_193del in the NDUFAF2 gene, inherited from each parent, meeting the pathogenic variant criteria of the American College of Medical Genetics and Genomics. Autopsy showed pulmonary artery dilation and myocardial hypertrophy, with no evidence of alveolar capillary dysplasia on lung tissue electron microscopy. Mutations in the NDUFAF2 gene are associated with mitochondrial complex I deficiency. This is the first reported case associating NDUFAF2 mutations with neonatal primary pulmonary hypertension, providing new genetic evidence for this condition and highlighting the importance of genetic and pathological studies in severe neonatal diseases.