不同胎龄及出生体重新生儿无创超声心输出量参数值测定  

Non-invasive ultrasound cardiac output monitor of hemodynamic parameters in neonates with different gestational age and birth weight

作　　者：洪文超 龚小慧[1] 裘刚[1] 蔡成[1] 马俐 颜崇兵[1] Hong Wenchao;Gong Xiaohui;Qiu Gang;Cai Cheng;Ma li;Yan Chongbing(Department of Neonatology,Shanghai Children's Hospital,Shanghai Jiao Tong University,Shanghai 200062,China)

机构地区：[1]上海市儿童医院,上海交通大学附属儿童医院新生儿科,200062

出　　处：《中华新生儿科杂志（中英文）》2021年第6期8-11,共4页Chinese Journal of Neonatology

摘　　要：目的应用无创超声心输出量监测仪对不同胎龄及出生体重的新生儿进行无创血流动力学监测,探讨其与胎龄和出生体重的相关性。方法选择2019年3~9月上海市儿童医院新生儿科收治的血流动力学稳定的新生儿进行前瞻性研究,按胎龄分为<29周组、29~33周组、34~36周组、≥37周组,按出生体重分为<1000 g组、1000~1499 g组、1500~2499 g组、≥2500 g组。通过无创超声心输出量监测仪测定新生儿心率(heart rate,HR)、心输出量(cardiac output,CO)、心脏指数(cardiac index,CI)、每搏输出量(stroke volume,SV)、心肌收缩力(inotropy,INO)、校正血流时间(flow time corrected,FTC)、系统血管阻力指数(systemic vascular resistance index,SVRI)。应用单因素线性回归方法分析不同胎龄或出生体重与血流动力学参数的相关性。结果共纳入120例,男69例,胎龄(34.2±3.8)周,出生体重(2221±860)g。SV(r=0.489,P<0.001)、CO(r=0.681,P<0.001)、CI(r=0.348,P<0.001)、FTC(r=0.266,P=0.003)、INO(r=0.446,P<0.001)、HR(r=-0.322,P<0.001)与胎龄存在线性相关性,SVRI(r=-0.052,P=0.574)与胎龄不存在线性相关性。SV(r=0.603,P<0.001)、CO(r=0.852,P<0.001)、CI(r=-0.390,P<0.001)、INO(r=0.576,P<0.001)、HR(r=-0.440,P<0.001)与出生体重存在线性相关性,SVRI(r=-0.076,P=0.409)、FTC(r=0.090,P=0.329)与出生体重不存在线性相关性。结论无创超声心输出量监测仪可实时监测新生儿血流动力学参数,SV、CO、CI、INO、HR在不同胎龄或出生体重新生儿中明显不同,且与胎龄和体重成线性相关。Objective To study the correlations of neonatal hemodynamic parameters with gestational age(GA)and birth weight(BW)using non-invasive ultrasound cardiac output monitor(USCOM).Method From March to September 2019,neonates with stable hemodynamics admitted to the Department of Neonatology of our hospital were enrolled in this prospective study.According to their GA,they were assigned into<29 w group,29~33 w group,34~36 w group and≥37 w group.According to their BW,they were assigned into<1000 g group,1000~1499 g group,1500~2499 g group and≥2500 g group.Cardiac output(CO),cardiac index(CI),stroke volume(SV),myocardial contractility(inotropy,INO),flow time corrected(FTC),systemic vascular resistance index(SVRI)and heart rate(HR)were measured using USCOM.The univariate linear regression method was used to analyze the correlation of hemodynamic parameters with different GA and BW.Result A total of 120 neonates with stable hemodynamics were enrolled,including 69 males and 51 females.The average GA was(34.2±3.8)w and the average BW was(2221±860)g.SV(r=0.489,P<0.001),CO(r=0.681,P<0.001),CI(r=0.348,P<0.001),FTC(r=0.266,P=0.003),INO(r=0.446,P<0.001)and HR(r=-0.322,P<0.001)showed significant linear correlations with GA.No linear correlation existed between SVRI(r=-0.052,P=0.574)and GA.SV(r=0.603,P<0.001),CO(r=0.852,P<0.001),CI(r=-0.390,P<0.001),INO(r=0.576,P<0.001)and HR(r=-0.440,P<0.001)showed significant linear correlations with BW.No significant linear correlations existed between SVRI(r=-0.076,P=0.409)or FTC(r=0.090,P=0.329)and BW.Conclusion USCOM can monitor neonatal hemodynamic parameters in real-time.Hemodynamic parameters including SV,CO,CI and INO are significantly different among newborns with different GA and BW and these parameters are linearly correlated with GA and BW.

关 键 词：血流动力学监测仪 血流动力学参数 婴儿 新生 出生体重 胎龄 

分 类 号：R722.1[医药卫生—儿科]