摘要
目的探讨影响早产儿早期脑血流的主要因素。方法住院早产儿261例,分为生后1、3d组各90例,7d组81例。应用经颅多普勒超声监测3组早产儿大脑中动脉血流速度及血管弹性。应用彩色多普勒超声心动图监测早产儿心输出量(CO)及主动脉瓣口峰值流速,同时监测生后1d组早产儿的体温、血气、血糖、血压及红细胞比积,并记录其胎龄及出生体重,应用多元逐步回归分析分析上述多因素对早产儿脑血流的影响。结果影响早产儿早期脑血流改变的因素有平均动脉压(MBP)、体温(T)、每分心输出量(CO)、动脉血二氧化碳分压(PaCO2)及红细胞比积(HCT),MBP、T、CO、PaCO2、HCT与大脑中动脉平均血流速度(Vm)的回归系数分别为0·458、5·332、10·385、0·095、-0·159。胎龄、出生体重与Vm正相关(r=0·28,r=0·41,P均<0·01)。脑血流速度均随日龄的增加而增加,其中收缩期峰值流速增加趋势最明显。3d组的血管弹性最低,明显低于7d组(P<0·05)。结论CO、T、MBP、PaCO2、HCT、胎龄、日龄及出生体重是影响早产儿早期脑血流变化的主要因素。
Objective To study the major factors affecting cerebral blood flow in early age of preterm infants. Methods Two hundred and sixty-one preterm infants admitted to the Hospital were enrolled in this study. The infants were assigned into three groups, 1 day （90 cases）, 3 days （90 cases） and 7 days （81 cases） post-delivery. The rate of blood flow and the elasticity of arteria cerebri media were measured by transcranial Doppler on the first, third and the seventh day in different groups. The cardiac output （CO） and the rate of peak flow of aorta valve orifice were measured by the color Doppler echocardiography. Meanwhile, the temperature （T）, blood gas, blood glucose, blood pressure and hematocrit （HCT） were measured on the first day in 1 day group infants; and their gestational age and birth weight were recorded. The factors affecting cerebral blood flow in the early age of preterm infants were analysed by multivariant stepwise regression analysis. Results Factors affecting cerebral blood flow were mean arterial pressure （MBP）, T, CO, arterial partial pressure of carbon dioxide （ PaCO2 ）, HCT. The regression coefficient between MBP, T, CO, PaCO2, HCT and mean velocity （Vm） of arteria cerebri media were 0. 458, 5. 332, 10. 385, 0. 095 and - 0. 159 respectively. There were positive correlations between gestational age, birth weight and Vm （r =0. 28 and 0. 41 respectively, P 〈0. 01 ）. The velocity of cerebral blood flow gradually increased with aging, especially the tendency of acceleration of peak velocity of systolic phase. The elasticity of blood vessel in 3 day group was the lowest and it was significantly lower than that of the seventh day （P 〈 0. 05 ）. Conclusion The factors affecting cerebral blood flow in the early stage of preterm chronological age and birth weight.
出处
《中国新生儿科杂志》
CAS
2008年第3期145-148,共4页
Chinese Journal of Neonatology
基金
深圳市科技计划项目(200602080)
关键词
血流速度
因素分析
统计学
超声检查
多普勒
彩色
Blood flow velocity
infants are CO, T, MBP, PaCO2, HCT, gestational age, Factor analysis, statistical
Ultrasonography, Doppler, color
