DiPietro J A, Porges S W
Department of Maternal and Child Health, Johns Hopkins University, Baltimore, Maryland 21205.
Pediatr Res. 1991 Mar;29(3):231-6. doi: 10.1203/00006450-199103000-00003.
Vagal responsivity to orogastric stimulation is necessary for gastrointestinal function and may reflect autonomic regulation. Our study evaluated vagal responsivity during gavage feeding as an index of preterm clinical status. Vagal and behavioral responsivity of 26 preterm infants during gavage feeding was measured. Vagal tone was quantified with a noninvasive measure (vagal tone index) developed by Porges (Porges SW: U.S. patent 4,510.944, 1985), which extracts a valid measure of cardiac vagal tone from the ECG. The study investigated whether vagal tone changed during gavage feeding and whether individual differences in the vagal tone response pattern were related to clinical outcome. Infants who demonstrated an increase in vagal tone during feeding and a decrease after feeding had significantly shorter hospitalizations. This effect was independent of weight gain trajectories. Baseline levels of vagal tone were positively associated with subsequent weight gain. Traditional risk measures did not predict length of hospitalization independently of gestational age. This study represents the first documentation that small changes in cardiac vagal tone during gavage feeding, previously imperceptible to clinicians and researchers, may be quantitatively extracted from the ECG and provide an important index of clinical status.
迷走神经对口胃刺激的反应性是胃肠功能所必需的，可能反映自主神经调节。我们的研究评估了经口喂养期间的迷走神经反应性，作为早产儿临床状况的一个指标。测量了26例早产儿经口喂养期间的迷走神经和行为反应性。迷走神经张力通过Porges开发的一种非侵入性测量方法（迷走神经张力指数）进行量化（Porges SW：美国专利4,510.944，1985年），该方法从心电图中提取有效的心脏迷走神经张力测量值。该研究调查了经口喂养期间迷走神经张力是否发生变化，以及迷走神经张力反应模式的个体差异是否与临床结局相关。在喂养期间迷走神经张力增加且喂养后降低的婴儿住院时间明显较短。这种影响与体重增加轨迹无关。迷走神经张力的基线水平与随后的体重增加呈正相关。传统的风险指标不能独立于胎龄预测住院时间。本研究首次证明，经口喂养期间心脏迷走神经张力的微小变化，以前临床医生和研究人员难以察觉，现在可以从心电图中定量提取，并提供重要的临床状况指标。
