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窒息足月新生儿缺氧缺血性脑病时脑和内脏血流速度的变化。

Changes in cerebral and visceral blood flow velocities in asphyxiated term neonates with hypoxic-ischemic encephalopathy.

机构信息

Department of Radiology, University of Tartu, Puusepa 2, 51014 Tartu, Estonia.

出版信息

J Ultrasound Med. 2009 Nov;28(11):1471-80. doi: 10.7863/jum.2009.28.11.1471.

Abstract

OBJECTIVE

The purpose of this study was to evaluate changes in the Doppler blood flow velocity (BFV) in the cerebral and visceral arteries in asphyxiated term neonates.

METHODS

The BFV was measured in 47 asphyxiated and 37 healthy term neonates in the anterior cerebral artery, middle cerebral artery, basilar artery, internal carotid artery, celiac artery (CA), superior mesenteric artery (SMA), and renal artery (RA) up to the age of 60 to 149 days.

RESULTS

At the age of 12 to 120 hours after asphyxia, the mean BFV had increased, and the resistive index (RI) had decreased (P < .05) in all cerebral arteries in neonates with severe hypoxic-ischemic encephalopathy (HIE) compared with the control group. In neonates with severe HIE, the mean BFV in the RA had significantly decreased at the age of 3 to 240 hours, and the RI had increased at the age of 24 to 240 hours, normalizing by the age of 21 to 59 days compared with the control group (P < .05). In the SMA, a decreased mean BFV was found in neonates with severe HIE compared with those with mild to moderate HIE only at the age of 24 to 36 hours. In neonates with mild to moderate HIE, the mean BFV had increased in the SMA and CA compared with the control group at the age of 2 to 11.9 hours.

CONCLUSIONS

A severe alteration of the cerebral and visceral BFV takes place during the first days after asphyxia in neonates with different severities of HIE.

摘要

目的

本研究旨在评估窒息足月新生儿大脑和内脏动脉多普勒血流速度(BFV)的变化。

方法

对 47 例窒息和 37 例健康足月新生儿的大脑中动脉、大脑前动脉、基底动脉、颈内动脉、腹腔动脉(CA)、肠系膜上动脉(SMA)和肾动脉(RA)的 BFV 进行了测量,直至出生后 60 至 149 天。

结果

在窒息后 12 至 120 小时,与对照组相比,严重缺氧缺血性脑病(HIE)新生儿所有大脑动脉的平均 BFV 增加,阻力指数(RI)降低(P<.05)。在严重 HIE 新生儿中,RA 的平均 BFV 在出生后 3 至 240 小时内显著降低,RI 在出生后 24 至 240 小时内增加,与对照组相比,在出生后 21 至 59 天内正常化(P<.05)。在 SMA 中,与对照组相比,严重 HIE 新生儿的平均 BFV 在出生后 24 至 36 小时内显著降低。与对照组相比,轻度至中度 HIE 新生儿的 SMA 和 CA 的平均 BFV 在出生后 2 至 11.9 小时内增加。

结论

不同严重程度的 HIE 新生儿在窒息后最初几天内,大脑和内脏 BFV 发生严重改变。

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