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多普勒超声在早发型新生儿败血症中的应用

Utility of Doppler ultrasound in early-onset neonatal sepsis.

作者信息

Ratnaparkhi Chetana R, Bayaskar Madhura V, Dhok Avinash P, Bhende Vikrant

机构信息

Department of Radiodiagnosis and Imaging, NKP Salve Institute of Medical Sciences and Research Centre and Lata Mangeshkar Hospital, Digdoh Hills, Hingna Road, Nagpur, Maharashtra, India.

出版信息

Indian J Radiol Imaging. 2020 Jan-Mar;30(1):52-58. doi: 10.4103/ijri.IJRI_265_19. Epub 2020 Mar 30.

DOI:10.4103/ijri.IJRI_265_19
PMID:32476750
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7240890/
Abstract

BACKGROUND

Neonatal sepsis is an important cause of morbidity and mortality among newborns. As there is paucity of literature regarding early alteration of the cerebral blood flow (CBF) in neonatal sepsis our study aims to evaluate the changes in the CBF velocities and Doppler indices in neonates with early-onset neonatal sepsis (EONS) and to evaluate the predictive accuracy of cerebral blood flow velocities (CBFV) by using ultrasound Doppler as a diagnostic marker of EONS.

METHODS

This cross-sectional analytical study was conducted over a period of 2 years with 123 neonates enrolled in the study. The neonates were divided into two groups: Group I (with 54 neonates) - neonates with EONS and group II (with 69 neonates) - age-matched neonates without any signs of sepsis. Ultrasound Doppler examination was performed and the cerebral hemodynamics assessed in neonates during the first seventy two hours of life. Doppler indices and CBFV were measured in the internal carotid artery (ICA), middle cerebral artery (MCA), and vertebral artery (VA) of either side. Data were analyzed using the statistical program SPSS version 23.0 (SPSS Inc., Chicago, IL, USA). Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy were calculated at different selected cutoff values for CBFV parameters.

RESULTS

Lower resistance and higher peak systolic velocity and end diastolic velocity have been documented in neonates with EONS.

CONCLUSION

Our study shows that the cerebral hemodynamics in neonates with EONS is altered which can be assessed bedside by noninvasive ultrasound Doppler examination.

摘要

背景

新生儿败血症是新生儿发病和死亡的重要原因。由于关于新生儿败血症时脑血流（CBF）早期改变的文献较少，我们的研究旨在评估早发型新生儿败血症（EONS）患儿的CBF速度和多普勒指数变化，并以超声多普勒作为EONS的诊断标志物，评估脑血流速度（CBFV）的预测准确性。

方法

本横断面分析研究历时2年，共纳入123例新生儿。新生儿被分为两组：第一组（54例新生儿）为EONS患儿，第二组（69例新生儿）为年龄匹配且无任何败血症迹象的新生儿。在新生儿出生后72小时内进行超声多普勒检查并评估脑血流动力学。测量双侧颈内动脉（ICA）、大脑中动脉（MCA）和椎动脉（VA）的多普勒指数和CBFV。使用统计软件SPSS 23.0版（美国伊利诺伊州芝加哥市SPSS公司）进行数据分析。计算不同CBFV参数选定截断值时的敏感性、特异性、阳性预测值（PPV）、阴性预测值（NPV）和诊断准确性。

结果

EONS患儿表现出较低的阻力以及较高的收缩期峰值速度和舒张末期速度。

结论

我们的研究表明，EONS患儿的脑血流动力学发生了改变，可通过床边无创超声多普勒检查进行评估。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6651/7240890/992a69ab2a23/IJRI-30-52-g008.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6651/7240890/2a658093fac2/IJRI-30-52-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6651/7240890/bfce71600841/IJRI-30-52-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6651/7240890/1bef9aad64be/IJRI-30-52-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6651/7240890/d659945dd24d/IJRI-30-52-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6651/7240890/1588b79b2f61/IJRI-30-52-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6651/7240890/7be304a3ef7c/IJRI-30-52-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6651/7240890/4c75da3ced58/IJRI-30-52-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6651/7240890/992a69ab2a23/IJRI-30-52-g008.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6651/7240890/2a658093fac2/IJRI-30-52-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6651/7240890/bfce71600841/IJRI-30-52-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6651/7240890/1bef9aad64be/IJRI-30-52-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6651/7240890/d659945dd24d/IJRI-30-52-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6651/7240890/1588b79b2f61/IJRI-30-52-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6651/7240890/7be304a3ef7c/IJRI-30-52-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6651/7240890/4c75da3ced58/IJRI-30-52-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6651/7240890/992a69ab2a23/IJRI-30-52-g008.jpg

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Sepsis-associated encephalopathy: A review of literature.脓毒症相关性脑病：文献综述
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