早产儿主动脉瓣区血流动力学参数变化特征研究  

Changes of hemodynamic parameters in aortic valve region of preterm infants

作　　者：李文丽[1] 魏思凡 邢景月 牛铭 赵越 赵晨静 董慧芳[1] 徐发林[1] Li Wenli;Wei Sifan;Xing Jingyue;Niu Ming;Zhao Yue;Zhao Chenjing;Dong Huifang;Xu Falin(Department of Neonatology,the Third Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第三附属医院新生儿科,郑州450052

出　　处：《中华新生儿科杂志（中英文）》2024年第10期592-598,共7页Chinese Journal of Neonatology

基　　金：河南省医学科技攻关计划联合共建项目(LHGJ20190350)。

摘　　要：目的探讨早产儿生后14 d内主动脉瓣区血流动力学参数随日龄增加的变化特征。方法选择2023年3~12月郑州大学第三附属医院新生儿重症监护室收治的循环稳定的早产儿进行前瞻性队列研究,于生后1、3、7、14 d应用无创超声心输出量监测仪测定主动脉瓣区血流动力学参数。按照监测日龄分为1 d组、3 d组、7 d组和14 d组,分析早产儿生后早期血流动力学参数随日龄增加的变化趋势,并按胎龄分为<32周和≥32周亚组,按出生体重分为<1500 g和≥1500 g亚组,进一步分析不同胎龄和出生体重早产儿血流动力学参数的变化情况。结果共纳入131例早产儿,生后早期主动脉瓣区心输出量、心脏指数、峰值速度、速度时间积分、心率、分钟距离、每搏指数、肌力指数随日龄增加呈上升趋势,外周血管阻力、外周血管阻力指数、流动时间随日龄增加呈下降趋势,射血时间百分比、校正流动时间随日龄增加呈先上升再下降趋势,差异均有统计学意义(P<0.05);每搏心输出量和每搏变异度在生后1~14 d较为稳定,随日龄增加的变化无统计学意义(P>0.05)。在不同胎龄、出生体重亚组中,心输出量、心脏指数、外周血管阻力有相同的变化趋势,在不同出生体重亚组中外周血管阻力指数变化趋势有所不同。结论早产儿生后14 d内主动脉瓣血流动力学参数随日龄增加呈现动态变化趋势。ObjectiveTo study the hemodynamic parameters changes of aortic valve region in preterm infants within 14 d after birth with increasing age.MethodsPreterm infants with stable circulation admitted to the Neonatal Intensive Care Unit of the Third Affiliated Hospital of Zhengzhou University from March to December 2023 were enrolled in this prospective cohort study.The hemodynamic parameters of aortic valve area were measured by non-invasive ultrasonic cardiac output monitor on day 1,3,7,and 14 after birth.According to the monitoring age,preterm infants were divided to 1 d,3 d,7 d and 14 d group.The trend of changes in early postnatal hemodynamic parameters with increasing age were analyzed.Furthermore,preterm infants were divided into subgroup of<32 and≥32 weeks according to gestational age(GA),and subgroups of<1500 g and≥1500 g according to birth weight(BW),the changes of hemodynamic parameters of preterm infants with different GA and BW were analyzed based on this stratification.ResultsA total of 131 preterm infants were included.Early postnatal aortic valve cardiac output,cardiac index,peak velocity,velocity-time integral,heart rate,minute distance,stroke volume index and muscle strength index showed an increasing trend with age,while peripheral vascular resistance,peripheral vascular resistance index and flow time showed a downward trend with age.Ejection time percentage and corrected flow time increased first and then decreased with age,and all the differences were statistically significant(P<0.05).Stroke volume and stroke volume variability remained relatively stable from day 1 to day 14 after birth,with no statistically significant changes with increasing age(P>0.05).In different gestational age and birth weight subgroups,cardiac output,cardiac index and peripheral vascular resistance had the same change trend,and peripheral vascular resistance index had different change trend in different weight subgroups.ConclusionsThe hemodynamic parameters of aortic valve in preterm infants within 14 d after birth show

关 键 词：超声心输出量监测 血流动力学参数 早产儿 不同日龄 

分 类 号：R722.6[医药卫生—儿科]