前脑动脉血流阻抗指数用于缺血缺氧性脑病的诊断  

Resistance Index of Anterior Cerebral Artery in the Diagnosis of Hypoxic Ischemic Encephapathy in Neonates

作　　者：王宏[1] 张振钧[1] 

机构地区：[1]上海医科大学附属妇产科医院

出　　处：《中华妇产科杂志》1995年第7期387-390,共4页Chinese Journal of Obstetrics and Gynecology

摘　　要：不得以连续波多普勒血流分析仪对１８２例正常新生儿（正常组）及６７例高危新生儿（异常组），分别进行了５３４次和２３０次前脑动脉血流阻抗指数（ＲＩ）测定。结果：正常组前脑动脉ＲＩ值分布范围为０．６２±０．０９（ｓ），其与日龄呈显著正相关（ｒ＝０．７２，Ｐ＜０．０５）；正常前脑动脉血流速度频谱图为规则图形。此外，在高危新生儿中，ＲＩ异常的标化发生率在有缺血缺氧性脑病（ＨＩＥ）病理基础的高危儿（甲组）中明显高于正常组（Ｐ＜０．００１），无ＨＩＥ病理基础的高危儿（乙组）则与正常组间差异无显著性（Ｐ＞０．０５）；同时，甲组的ＲＩ异常的标化发生率也明显高于乙组（Ｐ＜０．００１）。特别在９例有严重ＨＩＥ并发症者中，前脑动脉不规则血流图的标化发生率显著高于其他高危儿（Ｐ＜０．００１）。提示：从新生儿预后方面看，前脑动脉ＲＩ极度异常，尤其是有不规则血流图出现时，ＨＩＥ的严重并发症发生率及新生儿死亡率均急剧增高（Ｐ＜０．００１）。因此，前脑动脉ＲＩ异常提示有新生儿ＨＩＥ存在，特别当有不规则血流图出现时，新生儿预后多不良。bjective To study the relationship between the resistance index(RI)of the anterior cerebral artery and hypoxic ischemic encephapathy (HIE)in neonates for the purpose of finding outarnethod of diagnosing and predicting HIE and its prognosis。Metbod The anterior cerebral artery blood flow velocity waveform(aCAFV)of neonates was recorded by a continuous Doppler technique and RI value was measured.230 observations on 67 cases of high risk neonates and 534 on 182 normal neonates were perfomed.The mean value of RI and its stan- dard deviafion in normal neonates chosen served as control.The relationship between the standardized incidence of abnormal RI of the anterior cerebral artery and HIE was studied in high risk neonates. Result In normal neonates(control group),RI was 0.62 ± 0.09,and was in positive correlation(r=0. 72,P<0.05)with the davs after birth.The normal aCAFV was a regular waveform。In high risk neonates,the standardized incidence of abnormal RI in the neonates most likely to be attacked by HIE(Agroup)was significantly higher than that in control groiip(P<0.001),but there was no sig- nificant difference between the other babies(B group)and control group (P>0.05 ).However the standardized incidence of abnoimal RI in the A group was also significantly higher than that in the B group(P<0.001).In the cases who were severly attacked by HIE,the standardized incidenceof irreg-ular waveform was the highest.Furthermore,when irregular aCAFV waveform appears,the incidence of pernicious complication of HIE and monality of neonates were significantly increased in all cases。Conclusion The abnormal RI value of anterior cerebral artery implies the existence of HIE in neonates,The prognosis is poor when irregular blfor ffow waveform appears。

关 键 词：血流速度 脑缺血 脑缺氧 新生儿 阻抗指数 诊断 

分 类 号：R743.310.4[医药卫生—神经病学与精神病学]