Horne Rosemary S C, Fung Annie C H, NcNeil Scott, Fyfe Karinna L, Odoi Alexsandria, Wong Flora Y
The Ritchie Center, Hudson Institute of Medical Research and Department of Pediatrics, Monash University, Melbourne, Australia.
Department of Pediatrics, Chinese University of Hong Kong, Hong Kong, China.
J Pediatr. 2017 Mar;182:79-84. doi: 10.1016/j.jpeds.2016.11.081. Epub 2017 Jan 4.
To assess the incidence and impact of persistent apnea on heart rate (HR), oxygen saturation (SpO), and brain tissue oxygenation index (TOI) over the first 6 months after term equivalent age in ex-preterm infants.
Twenty-four preterm infants born between 27 and 36 weeks of gestational age were studied with daytime polysomnography at 2-4 weeks, 2-3 months, and 5-6 months post-term corrected age. Apneas lasting ≥3 seconds were included and maximal percentage changes (nadir) in HR, SpO and tissue oxygenation index (TOI, NIRO-200 Hamamatsu) from baseline were analyzed.
A total of 253 apneas were recorded at 2-4 weeks, 203 at 2-3 months, and 148 at 5-6 months. There was no effect of gestational age at birth, sleep state, or sleep position on apnea duration, nadir HR, SpO, or TOI. At 2-4 weeks, the nadirs in HR (-11.1 ± 1.2 bpm) and TOI (-4.4 ± 1.0%) were significantly less than at 2-3 months (HR: -13.5 ± 1.2 bpm, P < .05; TOI: -7.5 ± 1.1 %, P < .05) and at 5-6 months (HR: -13.2 ± 1.3 bpm, P < .01; TOI: -9.3 ± 1.2%, P < .01).
In ex-preterm infants, apneas were frequent and associated with decreases in heart rate and cerebral oxygenation, which were more marked at 2-3 months and 5-6 months than at 2-4 weeks. Although events were short, they may contribute to the adverse neurocognitive outcomes that are common in ex-preterm children.
评估晚期早产儿在足月等效年龄后的前6个月内持续性呼吸暂停对心率（HR）、血氧饱和度（SpO）和脑组织氧合指数（TOI）的发生率及影响。
对24例胎龄在27至36周之间出生的早产儿，在矫正胎龄2 - 4周、2 - 3个月和5 - 6个月时进行白天多导睡眠图检查。纳入持续时间≥3秒的呼吸暂停，分析HR、SpO和组织氧合指数（TOI，滨松NIRO - 200）相对于基线的最大百分比变化（最低点）。
在2 - 4周记录到253次呼吸暂停，2 - 3个月记录到203次，5 - 6个月记录到148次。出生胎龄、睡眠状态或睡眠姿势对呼吸暂停持续时间、最低心率、SpO或TOI均无影响。在2 - 4周时，HR（-11.1±1.2次/分）和TOI（-4.4±1.0%）的最低点显著低于2 - 3个月时（HR：-13.5±1.2次/分，P <.05；TOI：-7.5±1.1%，P <.05）和5 - 6个月时（HR：-13.2±1.3次/分，P <.01；TOI：-9.3±1.2%，P <.01）。
在晚期早产儿中，呼吸暂停频繁发生，并伴有心率和脑氧合下降，在2 - 3个月和5 - 6个月时比2 - 4周时更明显。尽管这些事件持续时间较短，但它们可能导致晚期早产儿常见的不良神经认知结局。
