Kocvarova Lenka, Mackovicova Lenka, Matasova Katarina, Zibolen Mirko
a Jessenius Faculty of Medicine in Martin , Clinic of Neonatology, Comenius University , Bratislava , Slovakia.
b Institute of Mathematics and Informatics , Matej Bel University , Banska Bystrica , Slovakia.
J Matern Fetal Neonatal Med. 2018 Nov;31(22):3027-3032. doi: 10.1080/14767058.2017.1362553. Epub 2017 Aug 13.
The objective of this study is to evaluate intestinal blood flow changes within the first 72 h in the late preterm infants in comparison with the healthy term neonates.
In this prospective study, we analyzed Doppler flow velocity waveforms of superior mesenteric artery (SMA) and coeliac trunc (TC) in 20 late preterm and 20 term infants at the age of 2, 24, and 72 h.
Significant end-diastolic velocity (end-diastolic velocity (EDV)) rise up to 24 h was documented in all patients (late preterm: -9.32 ± 9.48 to 17.01 ± 6.94; p < .05; term: -8 ± 5.74 to 12.39 ± 3.33; p < .001), associated with a conversion from negative values to positive ones. Reversed blood flow was documented in SMA at 2 h in 75% late preterm neonates. Preterm infants showed significantly higher mean peak systolic velocities (peak systolic velocity (PSV)), end-diastolic velocities (EDV) at 24 h and PSV at 72 h than term infants (p < .05). The resistance and pulsatility indices (PI) decreased within 24 h in both groups and inversely reflected the postnatal changes in EDV. Mean PI at 2 h was significantly higher in term neonates.
Late preterm neonates show similar progressive postnatal increase in blood flow velocities accompanied with a decrease in vascular resistance in SMA and TC then term neonates.
本研究的目的是评估晚期早产儿在出生后72小时内肠道血流的变化,并与健康足月儿进行比较。
在这项前瞻性研究中,我们分析了20名晚期早产儿和20名足月儿在2小时、24小时和72小时时肠系膜上动脉(SMA)和腹腔干(TC)的多普勒血流速度波形。
所有患者在24小时内舒张末期速度(EDV)均显著升高(晚期早产儿:从-9.32±9.48升至17.01±6.94;p<0.05;足月儿:从-8±5.74升至12.39±3.33;p<0.001),同时伴有血流值从负值转变为正值。75%的晚期早产儿在2小时时SMA出现反向血流。早产儿在24小时时的平均收缩期峰值速度(PSV)、舒张末期速度(EDV)以及在72小时时的PSV均显著高于足月儿(p<0.05)。两组的阻力指数和搏动指数(PI)在24小时内均下降,且与EDV的出生后变化呈负相关。足月儿在2小时时的平均PI显著更高。
与足月儿相比,晚期早产儿出生后血流速度同样呈现逐渐增加的趋势,同时SMA和TC的血管阻力降低。