Swarup Jyothi, Baker Robyn Wyman, Brozanski Beverly Sobchak, Yanowitz Toby Debra
Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pa., USA.
Biol Neonate. 2005;87(3):145-51. doi: 10.1159/000082290. Epub 2004 Nov 23.
In premature infants, intraventricular hemorrhage occurs more commonly in the left than the right hemisphere. We have demonstrated previously that cerebral blood flow velocity is lower in the left than the right middle cerebral artery in the first few hours after birth. This may be due to the open ductus arteriosus.
To test the hypothesis that blood flow velocity is lower in the left than the right middle cerebral artery only when the ductus arteriosus is open.
Infants born at 25-33 weeks' gestation were enrolled. Middle cerebral artery blood flow velocities and coefficients of variation were measured on the left, followed by the right, on days 1 and 7 of life. Echocardiography identified 67 infants (25-33 weeks, 517-2,371 g) whose ductus arteriosus was open on day 1 and closed on day 7.
Systolic (26.4 +/- 7.4 vs. 29.6 +/- 7.2 cm/s), mean (12.4 +/- 4.0 vs. 15.6 +/- 4.6 cm/s) and end-diastolic (5.3 +/- 2.2 vs. 6.8 +/- 2.9 cm/s) blood flow velocities were lower (p < 0.01) and the corresponding coefficients of variation were higher (p < 0.01) on the left on day 1. Neither the absolute Doppler blood flow velocities nor the coefficients of variation differed between the left and right sides on day 7.
Blood flow velocity is lower and more variable in the left compared to the right middle cerebral artery on day 1 of life in premature infants. These differences are not found on day 7. We speculate that this difference is due to the associated ductus arteriosus patency.
在早产儿中，脑室内出血在左半球比右半球更常见。我们之前已经证明，出生后的最初几个小时内，左大脑中动脉的脑血流速度低于右大脑中动脉。这可能是由于动脉导管未闭。
检验仅在动脉导管未闭时左大脑中动脉血流速度低于右大脑中动脉这一假设。
纳入妊娠25 - 33周出生的婴儿。在出生第1天和第7天，先测量左侧大脑中动脉血流速度及变异系数，然后测量右侧。超声心动图确定了67例婴儿（25 - 33周，体重517 - 2371克），其动脉导管在第1天开放，在第7天关闭。
出生第1天，左侧的收缩期（26.4±7.4对29.6±7.2厘米/秒）、平均（12.4±4.0对15.6±4.6厘米/秒）和舒张末期（5.3±2.2对6.8±2.9厘米/秒）血流速度较低（p<0.01），相应的变异系数较高（p<0.01）。第7天，左右两侧的绝对多普勒血流速度和变异系数均无差异。
早产儿出生第1天，左大脑中动脉的血流速度低于右大脑中动脉，且变化更大。第7天未发现这些差异。我们推测这种差异是由于相关的动脉导管未闭。
