摘要
目的:探讨脑室内出血(IVH)早产儿生后一周内大脑中动脉(MCA)血流动力学的变化,及胎龄(GA)、出生体重(BW)、平均动脉压(MABP)、日龄对IVH早产儿MCA的影响。方法:对110例早产儿应用超声技术检查颅脑,根据其颅脑声像分为无IVH组(对照组45例)、轻度IVH组(45例)和重度IVH组(20例),并分析MCA的血流动力学改变。结果:早产儿在生后1周内,MCA的收缩期峰速(Vs)、舒张末期速度(Vd)随着日龄的增加而升高。与对照组比较,轻度IVH早产儿3d内MCA的Vs明显增高(P<0.05),重度IVH的早产儿第1天MCA的Vs、Vd明显降低(P<0.05),两组IVH比较,重度IVH的早产儿7d内MCA的Vs及第1天的Vd均低于轻度组,差异有统计学意义(P<0.05)。两组IVH早产儿MCA的Vs与MABP呈正相关,(r分别为0.35和0.86,P<0.05)。结论:IVH早产儿生后24h内存在脑血流功能破环,MCA的Vs与MABP呈正相关,超声动态监测IVH早产儿的MABP及MCA血流参数改变对评价早产儿出血程度及判断预后有重要的临床意义。
Objective：To evaluate the hemodynamics of middle cerebral artery（MCA） in premature infants with intraventricular hemorrhage（IVH） and the effects of gestation age（GA）, birth weight（BW）,age and mean arterial blood pressure（MABP） on it. Methods：We detected the hemodynamics of MCA in 110 premature infants by color Doppler ultrasound. The data were divided into three groups according to their brain＇ s sonographic： control group （45 cases）, mild IVH group （45 cases） and severe IVH group （20 cases）. Results：Within 1 week, there was a linear increase of all velocities of MCA with increasing age. In the third day of postnatal in mild IVH group, the Velocity systolic（Vs） of MCA was obviously faster than that in control group （ P〈0. 05）. As compared with the other groups, the Vs in serious IVH group decreased significantly in the first day （ P 〈0.05）, which within seven days decreased compared to that in mild IVH group（ P〈0.05）. The correlation coefficients of Vs and MABP in both IVH groups were 0.35 and 0.86（ P 〈0.05）. Conclusion：There are differential levels of impaired cerebrovascular autoregulation within postnatal 24 hours in premature infants with IVH. Vs and MABP are positive correlated. St has very important clinical significance by color Doppler ultrasound to monitor the hemodynamics changes of MCA in IVH, and to evaluate the hemorrhage degree in premature infants for a better assessment of prognosis.
出处
《广西医科大学学报》
CAS
2010年第1期82-84,共3页
Journal of Guangxi Medical University
基金
国家"十一.五"科技支撑计划项目(No.2007BAI07A17-11)
关键词
超声
早产儿
脑室内出血
大脑中动脉
Ultrasound
Premature infants
Intracranial hemorrhage
Middle cerebral artery
