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早产儿体感通路的宫外成熟:一项体感诱发电位研究。

Extrauterine maturation of somatosensory pathways in preterm infants: a somatosensory evoked potential study.

作者信息

Tombini M, Pasqualetti P, Rizzo C, Zappasodi F, Dinatale A, Seminara M, Ercolani M, Rossini P M, Agostino R

机构信息

Neurologia Clinica, Università Campus Biomedico, Via Alvaro del Portillo 200, Trigoria, 00128 Rome, Italy.

出版信息

Clin Neurophysiol. 2009 Apr;120(4):783-9. doi: 10.1016/j.clinph.2008.12.032. Epub 2009 Mar 18.

Abstract

OBJECTIVE

To evaluate the reliability of somatosensory evoked potential (SEP) recordings in preterm infants to monitor the intra-uterine and extrauterine maturation of somatosensory pathways.

METHODS

We performed SEPs in 35 neurologically normal preterm babies (range 23-35 weeks gestational age--GA). Twenty-four of all infants were evaluated after the first 2 weeks of life, at a minimum post-menstrual age (PMA) of 31 weeks, and 31 at term corrected age. In 15 infants we obtained longitudinal recordings at both epochs. Cross-sectional and longitudinal values of first cortical potential (N1) were analyzed in relation of PMA and matched with those measured in a group of 11 fullterm babies.

RESULTS

Reproducible cortical SEPs were found in 92% of preterm babies at first recording, and in all 31 neonates at follow-up. A significant inverse correlation between the latency values of N1 and PMA at the time of first recording was observed, showing that latencies of these components rapidly decrease with increasing PMA. Regression analysis showed no significant effect on N1 latency at term correct age in dependence of GA, suggesting that extrauterine life does not affect maturation of somatosensory pathways. Interestingly, the occurrence of idiopathic respiratory distress (RDS) during clinical course after birth correlated with a delayed N1 latency at term corrected age.

CONCLUSIONS

Extrauterine life does not affect maturation of somatosensory pathways in preterms without neurological deficit. Finally, the mild negative influence of RDS on maturational changes was evident.

SIGNIFICANCE

SEPs could be considered a useful tool for a non-invasive assessment of somatosensory pathways integrity in preterm infants.

摘要

目的

评估体感诱发电位(SEP)记录在早产儿中监测体感通路宫内及宫外成熟度的可靠性。

方法

我们对35名神经功能正常的早产儿(胎龄23 - 35周)进行了SEP检查。所有婴儿中,24名在出生后前2周、最小孕龄(PMA)为31周时接受评估,31名在足月矫正年龄时接受评估。在15名婴儿中,我们在两个阶段都获得了纵向记录。分析了首次皮层电位(N1)的横断面和纵向值与PMA的关系,并与一组11名足月儿测量的值进行匹配。

结果

首次记录时,92%的早产儿可记录到可重复的皮层SEP,随访时所有31名新生儿均能记录到。首次记录时观察到N1潜伏期值与PMA之间存在显著负相关,表明这些成分的潜伏期随PMA增加而迅速缩短。回归分析显示,足月矫正年龄时GA对N1潜伏期无显著影响,提示宫外生活不影响体感通路的成熟。有趣的是,出生后临床过程中特发性呼吸窘迫(RDS)的发生与足月矫正年龄时N1潜伏期延迟相关。

结论

宫外生活不影响无神经功能缺陷早产儿体感通路的成熟。最后,RDS对成熟变化的轻度负面影响是明显的。

意义

SEP可被认为是一种用于无创评估早产儿体感通路完整性的有用工具。

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