Coombs R C, Morgan M E, Durbin G M, Booth I W, McNeish A S
Institute of Child Health, University of Birmingham, U.K.
J Pediatr Gastroenterol Nutr. 1992 Jul;15(1):13-9. doi: 10.1097/00005176-199207000-00003.
Duplex pulsed Doppler ultrasound was used to determine blood flow velocities in the coeliac axis and superior mesenteric artery in three groups of neonates: a group at high risk of developing necrotising enterocolitis (n = 27) and two control groups, i.e., a nonasphyxiated, appropriately grown group of preterm infants (n = 18) and a group of nonasphyxiated term infants (n = 14). Subjects were studied on the first, second, and fourth days of life. The median peak systolic velocities in the superior mesenteric artery were between 20 and 51% lower in the at-risk group than in the term control group on all 3 days of measurement (p less than 0.05-p less than 0.002). The ratio of peak systolic velocity in the coeliac axis to that in superior mesenteric artery, an index of relative downstream vascular resistance in the superior mesenteric artery, was 42-65% greater in the at-risk group compared with the other two groups on days 1 and 2 (p less than 0.05-p less than 0.001) and significantly greater than the term group on day 4 (73%, p less than 0.002). These data demonstrate that neonates at risk of developing necrotising enterocolitis have abnormal gut blood flow velocities. Furthermore, they provide evidence that an alteration in the splanchnic circulation may be an important factor in the final common pathway that links diverse risk factors for necrotising enterocolitis with clinical disease.
一组为发生坏死性小肠结肠炎高危组（n = 27），两个对照组，即一组非窒息、生长正常的早产儿（n = 18）和一组非窒息足月儿（n = 14）。在出生后第1、2和4天对研究对象进行检查。在测量的所有3天中，高危组肠系膜上动脉的收缩期峰值速度中位数比足月儿对照组低20%至51%（P<0.05 - P<0.002）。腹腔动脉与肠系膜上动脉收缩期峰值速度之比是肠系膜上动脉相对下游血管阻力的一个指标，在第1天和第2天，高危组与其他两组相比高42% - 65%（P<0.05 - P<0.001），在第4天显著高于足月儿组（73%，P<0.002）。这些数据表明，发生坏死性小肠结肠炎高危的新生儿肠道血流速度异常。此外，它们提供了证据，即内脏循环改变可能是将坏死性小肠结肠炎的多种危险因素与临床疾病联系起来的最终共同途径中的一个重要因素。
