高胆红素血症对新生儿脑血流指标的影响及相关性研究  

Study on effect and correlation of hyperbilirubinemia on neonatal cerebral hemodynamics index

作　　者：朱秀丽[1] 艾雪梅[2] 

机构地区：[1]河北医科大学第四医院儿科,河北石家庄050011 [2]河北医科大学第三医院儿科

出　　处：《中国妇幼保健》2014年第4期537-539,共3页Maternal and Child Health Care of China

基　　金：河北省卫生厅课题〔20120331〕

摘　　要：目的:探讨高胆红素血症与新生儿脑血流动力学指标的相关性。方法:选取95例高胆红素血症新生儿为观察组,另外选取50例正常健康新生儿为对照组,对比两组脑血流动力学指标的差异。结果:与对照组相比,观察组患儿舒张末期血流速度(Vd)、收缩期峰值流速(Vs)、时间平均流速(Vm)显著增加,而阻力指数(RI)、搏动指数(PI)显著减少(P<0.05)。其中高胆红素血症重度组Vd、Vs、Vm显著高于中、轻度组(P<0.05),而RI、PI则显著低于中、轻度组(P<0.05),中度组Vd、Vs、Vm显著高于轻度组(P<0.05),而RI、PI则显著低于轻度组(P<0.05)。随着患儿病情转归,高胆红素血症Vd、Vs、Vm、显著下降,而RI、PI显著上升,于治疗后第5天恢复至正常水平。经Person's相关因素分析可知,血胆红素水平与Vd、Vs、Vm呈正相关,而与RI、PI呈负相关。结论:高胆红血症可引起新生儿脑血流动力学指标紊乱,脑血流动力学指标与胆红素水平关系密切,可作为新生儿高胆红素血症病情进展及预后的评价指标。Objective： To investigate the correlation of hyperbilirubinemia and neonatal cerebral hemodynamics indexes. Methods： 95 cases of neonatal hyperbilirubinemia were selceted as observation group and 50 normal healthy newborns were selected as control group. The differences of cerebral hemodynamics indexes were compared in the two groups. Results： Compared to control group, the levels of dias- tolic velocity （Vd） , peak systolic velocity （Vs） , time -averaged velocity （Vm） of hyperbilirubinemia group were increased , while the re- sistance index （RI） , pulsatility index （PI） were reduced （ P 〈 0. 05 ） . The levels of Vd, Vs, Vm of severe hyperbilimbinemia group were higher than in the moderate and mild group, while the levels of RI, PI were significantly lower than in the moderate and mild groups. The lev- els of Vd, Vs, Vm of moderate group were higher than mild group, while the RI, PI was significantly lower than the mild group （ P 〈 0. 05 ） . With the outcome of children with the disease , Vd, Vs and Vm of hyperbilirubinemia decreased significantly, while the RI, PI in- creased significantly , and on 5 d after treatment returned to normal levels. The Person~ relevant factors analysis showed that serum bilirubin levels and Vd, Vs, Vm was positively correlated , while was negatively correlated with RI and PI. Conclusion： Hyperbilirnbinemia can cause neonatal cerebral hemodynamies index disorders, cerebral hemodynamics index are closely related to bilirubin levels, it ean be used as an indicator for neonatal hypcrbilirnbinemia progression and prognosis evaluation.

关 键 词：高胆红素血症 新生儿感染 血流动力学 

分 类 号：R722.1[医药卫生—儿科]