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从出生到2岁的自主神经成熟:正常值

Autonomic maturation from birth to 2 years: normative values.

作者信息

Patural Hugues, Pichot Vincent, Flori Sophie, Giraud Antoine, Franco Patricia, Pladys Patrick, Beuchée Alain, Roche Frédéric, Barthelemy Jean-Claude

机构信息

Neonatal Intensive Care Unit, Pediatric Department, University Hospital of Saint-Etienne, France.

EA SNA-EPIS 4607 Research Laboratory, University Saint-Etienne, France.

出版信息

Heliyon. 2019 Mar 7;5(3):e01300. doi: 10.1016/j.heliyon.2019.e01300. eCollection 2019 Mar.

Abstract

BACKGROUND

While heart rate variability (HRV) constitutes a relevant non-invasive tool to assess the autonomic nervous system (ANS) function with recognized diagnostic or therapeutic implications, there is still a lack of established data on maturation of autonomic control of heart rate during the first months of life. The Autonomic Baby Evaluation () cohort was built to establish, the normal autonomic maturation profile from birth up to 2 years, in a healthy population of full-term newborns.

METHODS

Heart rate variability analysis was carried out in 271 full-term newborns (mean gestational age 39 wGA + 5 days) from reliable polysomnographic recordings at 0 (n = 270) and 6 (n = 221) months and from a 24-hour ambulatory electrocardiogram (ECG) at 12 (n = 210), 18 (n = 197), and 24 (n = 190) months. Indices of HRV analysis were calculated through the software.

RESULTS

Indices are dissociated according a temporal, geometrical, frequency, Poincaré, empirical mode decomposition, fractal, Chaos and DC/AC and entropy analysis. Each index is presented for five different periods of time, 0, 6, 12, 18 and 24 months and with smoothed values in the 3rd, 10th, 50th, 90th and 97th percentiles. Data are also presented for the full cohort and individualized by sex to account for gender variability.

DISCUSSION & CONCLUSION: The physiological autonomic maturation profile from birth to 2 years in a healthy population of term neonates results in a fine-tuning autonomic maturation underlying progressively a new equilibrium and privileging the parasympathetic activity over the sympathetic activity.

摘要

背景

虽然心率变异性(HRV)是评估自主神经系统(ANS)功能的一种重要非侵入性工具,具有公认的诊断或治疗意义,但在生命的最初几个月中,关于心率自主控制成熟度的既定数据仍然缺乏。建立了自主婴儿评估()队列,以确定足月新生儿健康人群从出生到2岁的正常自主成熟情况。

方法

对271名足月新生儿(平均胎龄39周+5天)进行心率变异性分析,分别在0个月(n = 270)和6个月(n = 221)时通过可靠的多导睡眠图记录,以及在12个月(n = 210)、18个月(n = 197)和24个月(n = 190)时通过24小时动态心电图(ECG)进行记录。通过软件计算HRV分析指标。

结果

指标根据时间、几何、频率、庞加莱、经验模式分解、分形、混沌以及直流/交流和熵分析进行区分。每个指标呈现五个不同时间段的数据,即0、6、12、18和24个月,并给出第3、10、50、90和97百分位数的平滑值。还给出了整个队列的数据,并按性别进行个体化分析,以考虑性别差异。

讨论与结论

足月新生儿健康人群从出生到2岁的生理性自主成熟情况导致自主成熟的微调,逐渐形成新平衡,并使副交感神经活动优于交感神经活动。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9931/6407160/cca77087d7ca/gr1.jpg

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