早产儿脑血流的超声多普勒研究  

Cerebral Blood Flow Velocities Evaluated by Doppler Ultrasonography in Preterm Infants

作　　者：李革[1] 李玖军[1] 毛健[1] 

机构地区：[1]中国医科大学第二临床学院新生儿科

出　　处：《中华围产医学杂志》2003年第6期333-337,共5页Chinese Journal of Perinatal Medicine

摘　　要：目的　测定正常早产儿和窒息早产儿的颅内动脉血流速度 ,分析影响正常早产儿脑血流的因素及窒息早产儿脑血流的变化规律。　方法　应用超声多普勒测定 2 5例正常早产儿及 17例窒息早产儿脑血流参数。　结果　正常早产儿颈内动脉 (ICA)、大脑前动脉 (ACA)的收缩期峰值血流速度 (Vs)、平均血流速度 (mV )于第 2天以后各组与第 1天比较差异有显著性 ;正常早产儿脑血流速度与胎龄 (GA)、出生体重 (BW )呈正相关 ,ICA、ACA的Vs、舒张末期速度 (Vd)、mV与GA的相关系数 (r)分别为 0 .42、0 .18、0 .17、0 .2 5、0 .17、0 .17;与BW的r分别为 0 .3 8、0 .2 6、0 .2 1、0 .3 5、0 .2 1、0 .2 0。窒息早产儿ICA、ACA的Vs、Vd、mV(cm /s)在生后 2 4h内明显下降 ,分别为 2 8.1± 8.5、5.5±2 .3、12 .6± 4.0、15.4± 5.6、4.2± 3 .0、8.3± 3 .6,与正常组相比P值分别 <0 .0 5、0 .0 1、0 .0 1、0 .0 1、0 .0 1、0 .0 1,第 2天后逐渐升高 ;窒息早产儿的脑血流速度与平均动脉血压 (MABP)呈正相关 ,ICA、ACA的Vs、Vd、mV与MABP的r值分别为 0 .3 3、0 .40、0 .2 8、0 .3 3、0 .3 0、0 .3 9。　结论　在评价早产儿脑血流灌注状态时 ,应注意GA、BW、日龄对其的影响 ;窒息早产儿脑血流改变的主要方式为窒息早期脑血流速度?ObjectiveTo study the characteristics factors of cerebral blood flow (CBF) healthy and asphyxiated preterm infants.Met hodsParameters of CBF in internal carotid artery (ICA) and anterior cerebral artery (ACA) were measured in 25 normal prematures and 17 asphyxiated prematures by Doppler.ResultsIn healthy infants, there was a linear increase of all velocities of ICA and ACA with increasing gestational age (GA) and birth weight (BW), the correlation coefficients of the peak systolic velocity(Vs), end diastolic velocity(Vd), mean peak velocity(mV) with GA in ICA, ACA are 0.42, 0.18, 0.17, 0.25, 0.17, 0.17, with BW in ICA, ACA are 0.38, 0.26, 0.21, 0.35, 0.21, 0.20. There was an obvious increase i n Vs and mV of two arteries over the second day of life. In asphyxiated infants , there was a linear increase of all velocities with mean artery blood pressure(MABP), the correlation coeffici ents betweenVs, Vd, mV and MABP in ICA, ACA are 0.33, 0.40, 0.28, 0.33, 0.30, 0. 39, and Vs, Vd, mV in ICA, ACA decreased significantly(28.1±8.5, 5.5±2.3, 12.6±4.0,15.4±5.6, 4.2±3.0, 8.3±3.6 respectively ) compared with those of the normal group.Con clusionsThere was a positive correlation between CBF and BW, GA, Attention m ust be paid to these factors, when evaluating CBF The main change of CBF in asphyxiated preterm infants was velocity decrease So it is important to maintain steady MABP in preventing and treating HIBI.

关 键 词：早产儿 脑血流 多普勒超声检查 窒息 影响因素 

分 类 号：R722.6[医药卫生—儿科] R445.1[医药卫生—临床医学]