新生儿出生时脑氧合及血流改变的近红外光谱研究  

The study of brain oxygenation and cerebral blood flow in post-birth newborns using near infrared spectroscopy

作　　者：侯新琳[1] 杨慧霞[2] 周丛乐[2] 丁海曙[1] 吴成[2] 丁海艳[1] 

机构地区：[1]清华大学医学院生物医学工程系,北京100084 [2]北京大学第一医院,北京100034

出　　处：《中国医刊》2007年第3期26-29,共4页Chinese Journal of Medicine

基　　金：国家自然科学基金(60578004);中国博士后基金(20060390476)

摘　　要：目的 研究正常新生儿出生后脑氧合及血流的变化规律，以及宫内窘迫、妊娠高血压疾病、妊娠糖尿病对初生新生儿脑氧合及血流的影响。方法 用近红外光谱技术检测初生新生儿脑组织还原血红蛋白浓度CHb和氧合血红蛋白浓度CHbO2的变化值及反应脑氧合的氧饱和度rSO2绝对值，进一步得到反应脑血容量的CtHb=CHb＋CHbO2，反应脑灌注的CHbD=CHbO2-CHb。结果 正常新生儿出生后2～5分钟，rSO2呈上升的趋势；CtHb相对稳定；CHbD呈上升的趋势。母亲合并妊娠高血压疾病的新生儿生后4～5分钟脑血流CtHb明显高于正常儿，P〈0．05；生后2～5分钟脑灌注CHbD明显低于正常足月儿，P〈0．05。母亲合并妊娠糖尿病的新生儿生后4～5分钟脑血流CtHb明显高于正常儿。宫内窘迫的新生儿rSO2、CtHb、CHbD的变化规律接近足月儿。结论 正常新生儿出生后2～5分钟，脑氧合增加，脑血流稳定、脑灌注增加。妊娠高血压疾病对脑灌注的影响延续至生后5分钟。经过积极的产科处理，宫内窘迫和妊娠糖尿病对新生儿脑氧合及灌注影响不大。Objective To study the changing patterns of brain oxygenation and cerebral blood flow in normal postbirth newborns and understand the influences of intrauterine distress, pregnancy-induced hypertension syndrome and gestational diabetes mellitus upon the brain oxygenation and cerebral blood flow in early newborns. Methods The authors employed the technology of NIRS （ near infrared spectroscopy） monitor the change values of CHb, CHbO2 and the absolute values rSO2 in newborn brain, the reacting brain blood volume of CtHb = CHb ＋ CHbO2 and brain perfusion CHbD = CHbO2 - CHb was further obtained. Results At 2 -5Min in normal newborns,the trends of rSO2 ,CHbD were rising, the CtHb were stable respectively. At 2- 5min post-birth in newborns whose mothers were complicated with pregnancy-induced hypertension syndrome, the CtHb at 4- 5min were high than normal newborn, there were significant differences between them. The CHbD was lower than the normal controls at 2 - 5min post-birth, there were significant differences between them. In the newborns whose mothers were complicated with diabetes mellitus, the CtHb at 4-5min were high than normal newborn, there were significant differences between them. Intrauterine distress caused no major changes of rSO2 ,CtHb,CHbD in early newborns. Conclusion At 2 - 5min post-birth in normal newboms, brain oxygenation increased, brain flow stable, brain perfusion increased. The effects of pregnancy-induced hypertension syndrome extended until 5min post-birth. After active obstetric interventions, intrauterine distress and gestational diabetes mellitus had no major influences upon neonate brain oxygenation and perfusion.

关 键 词：脑氧合 脑血流 近红外光谱 新生儿 

分 类 号：R722[医药卫生—儿科]