Robel-Tillig E, Vogtmann C
Department of Pediatrics, University of Leipzig, Germany.
Acta Paediatr. 2000 Aug;89(8):971-4. doi: 10.1080/080352500750043459.
Doppler sonographic investigations have presented cerebral hyperperfusion in neonates after severe asphyxia. Neonates with disturbed cerebral blood flow velocity (CBFV) tend to have poor outcomes. The purpose of this clinical study was to examine the influence of aminophylline on cerebral hyperperfusion. An intravenous bolus of 4 mg/kg aminophylline was given to nine neonates with Doppler sonographic signs of cerebral hyperperfusion. CBFV was determined before, 5 min, 60 min and 120 min after aminophylline administration and on the following day. After aminophylline the mean systolic (56.5 vs. 41.6 cm/s) and end diastolic (21.0 vs. 12.3 cm/s) blood flow velocity decreased and the mean pulsatility index (0.83 vs. 1.1) increased significantly. Repeated measurements showed a decrease in blood flow velocities and an increase in pulsatility index on the following days. Heart rate, mean arterial blood pressure and pCO2 were not significantly changed. We conclude that aminophylline influences cerebral hyperperfusion in neonates with disturbed autoregulation.
多普勒超声检查显示,重度窒息后的新生儿存在脑血流灌注过多的情况。脑血流速度(CBFV)紊乱的新生儿往往预后较差。本临床研究的目的是检验氨茶碱对脑血流灌注过多的影响。对9例有脑血流灌注过多多普勒超声征象的新生儿静脉推注4mg/kg氨茶碱。在给予氨茶碱前、给药后5分钟、60分钟和120分钟以及次日测定CBFV。给予氨茶碱后,平均收缩期血流速度(56.5对41.6cm/s)和舒张末期血流速度(21.0对12.3cm/s)降低,平均搏动指数(0.83对1.1)显著升高。重复测量显示,随后几天血流速度降低,搏动指数升高。心率、平均动脉血压和pCO2无显著变化。我们得出结论,氨茶碱对自身调节紊乱的新生儿的脑血流灌注过多有影响。