新生儿早期脑血流动力学变化特点

doi:10.3969/j.issn.1671-7171.2019.11.009

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摘要 【目的】探讨新生儿早期脑血流动力学变化特点。【方法】应用彩色多普勒超声诊断仪检测142例新生儿,分别在出生后24 h内、24~48 h、48~72 h检测大脑中动脉收缩期血流速度(Vs),舒张期峰速度(Vd)以及阻力指数(RI)并分析其临床特点。【结果】142例新生儿男87例,女55例;胎龄28⁺⁴~44周;出生体质量950~4650 g。出生后24 h内、24~48 h、48~72 h大脑中动脉收缩期Vs、Vd 及RI三组间比较,差异具有统计学意义(P<0.01)。根据出生体质量分为~1500 g,~2500 g,>2500 g三组,三组间Vs、Vd及RI比较,差异具有统计学意义(均P<0.01)。根据胎龄分为~37周、37⁺¹~42周、>42周三组,三组间Vs、Vd及RI比较,差异具有统计学意义(均P<0.01)。根据出生时有无窒息分为无窒息、轻度窒息、中度窒息、重度窒息四组,四组间Vs、Vd及RI比较,差异具有统计学意义(均P<0.01)。比较有无宫内窘迫两组的血流动力学特点,两组间Vs、Vd及RI比较,差异具有统计学意义(均P<0.01)。【结论】新生儿早期大脑中动脉的血流动力学变化在不同的日龄段有所不同。其影响因素分别有出生时有无窒息、宫内有无窘迫、出生胎龄、出生体质量等。

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关键词 ：婴儿, 新生, 血流动力学

Abstract：【Objective】To investigate the characteristics of cerebral hemodynamic changes in the early neonatal period. 【Methods】A total of 142 neonates were detected by color Doppler ultrasound in our hospital. Systolic blood flow velocity (Vs), peak diastolic blood flow velocity (Vd) and resistance index (RI) of the middle cerebral artery were measured within 24 hours, 24-48 hours and 48-72 hours after birth. Statistical methods SPSS17.0 was used for statistical analysis. 【Results】Among the 142 newborns, there were 87 males and 55 females with gestational age of 28⁺⁴-44 weeks and birth weight of 950-4650 g. The comparison of Vs(cm/s), Vd (cm/s) and RI of the middle cerebral artery within 24 hours, 24-48 hours and 48-72 hours after birth were statistically significant (P<0.01). According to the birth weight, newborn babies were divided into three groups: <1500g,1500g-2500g and >2500g. The values of Vs, Vd and RI in the three groups were compared and the differences were statistically significant (P<0.01). Meanwhile the differences of Vs, Vd and RI in three gestational age groups (<37 weeks, 37⁺¹-42 weeks and > 42 weeks) The Vs, Vd, and RI were statistically significant (P<0.01). Also, the differences in Vs, Vd and RI among no asphyxia, mild asphyxia, moderate asphyxia and severe asphyxia groups at birth were statistically significant (P<0.01). Lastly, hemodynamic characteristics of the intrauterine distress group and the non-intrauterine distress group were compared. The result showed that the differences were statistically significant (P<0.01). 【Conclusion】The hemodynamic changes of the middle cerebral artery in early neonatal period are different. The influencing factors include birth asphyxia, intrauterine distress, gestational age and birth weight.

Key words： Infant, Newborn Hemodynamics

收稿日期: 2019-07-28

PACS:

R715.8

基金资助:新疆自治区科技厅科技援疆项目(2018E02104)

引用本文:

刘新晖, 努尔依马汗·买买提, 高喜容, 耿玉霞, 朱婕, 房艳珍. 新生儿早期脑血流动力学变化特点[J]. 医学临床研究, 2019, 36(11): 2109-2111.
LIU Xin-hui, Nur ima khan Maimait, GAO Xi-rong, et al. Characteristics of Cerebral Hemodynamics in Early Neonatal Period. JOURNAL OF CLINICAL RESEARCH, 2019, 36(11): 2109-2111.

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http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2019.11.009 或 http://journal07.magtech.org.cn/yxlcyj/CN/Y2019/V36/I11/2109