重度窒息新生儿5分钟Apgar评分的心率变异性分析  

Association of heart rate variability with 5-minute Apgar score in neonates with severe asphyxia

作　　者：王瑾[1] 李丽[1] 阚亚楠[1] 梁宏伟[1] 陈家菲[1] 

机构地区：[1]唐山市妇幼保健院,河北唐山063000

出　　处：《临床儿科杂志》2013年第9期817-819,共3页Journal of Clinical Pediatrics

基　　金：唐山市科学技术研究与发展计划指导项目(No.091302186)

摘　　要：目的探讨重度窒息新生儿5minApgar评分与心率变异性（HRV）的关系。方法入选103例出生后1minApgar评分为0-3分的重度窒息新生儿，根据出生后5minApgar评分分组，〉7分为A组（n=50），≤7分B组（n=53）；同时以40例1、5minApgar评分均〉7分的足月新生儿作为对照组；三组新生儿均于出生后第3天行24h动态心电图检查，并分析其HRV变化。结果B组较对照组及A组HRV时域指标PNN50、rMSSD、SDSD降低，SDNN、SDANN升高，差异均有统计学意义（P〈0．05）；而A组与对照组HRV时域指标差异无统计学意义（P〉0．05）。结论新生儿窒息损伤自主神经功能，5minApgar评分联合HRV时域参数可作为重度窒息新生儿自主神经功能损伤及预后的无创判断指标。Objective To explore the relationship between 5-minute Apgar score and heart rate variability （HRV） in severely asphyxiated neonates. Methods A total of 103 severely asphyxiated neonates with 1- minute Apgar score of 0 to 3 points were selected. They were divided into Group A （〉7 points, n=50） and Group B （≤7 points, n=53） based on 5-minute Apgar score. Meanwhile, 40 full-term neonates with 1- and 5-minute Apgar score greater than 7 points were selected as control group. 24-hour dynamic electrocardiogram was performed and HRV was analyzed on the third day after birth in three groups. Results PNN50, rMSSD, SDSD were decreased and SDNN, SDANN were increased in group B as compared with group A and control group （P〈0.05）. No significant difference of HRV was observed between group A and control group （P〉0.05）. Conclusions Neonatal asphyxia can cause damage to autonomic nervous system. 5-minute Apgar score and HRV can be joint- ly used as a non-invasive index in autonomic nervous damage and its prognosis in asphyxiated newborns.

关 键 词：窒息 APGAR评分 心率变异性 自主神经功能损伤 新生儿 

分 类 号：R722.1[医药卫生—儿科]