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28-32 孕周早产儿 24 小时心率变异性测量的可重复性。

Reproducibility of 24-h heart rate variability measures in preterm infants born at 28-32 weeks of gestation.

机构信息

Physical Therapy Department, School of Health Professions, Sackler Faculty of Medicine, Tel Aviv University, Israel.

Shaare-Zedek Medical Center, Jerusalem, Israel.

出版信息

Early Hum Dev. 2020 Sep;148:105117. doi: 10.1016/j.earlhumdev.2020.105117. Epub 2020 Jun 20.

Abstract

AIMS

To determine the reproducibility and minimum detectable change (MDC) of heart rate variability (HRV) measures during two sequential 24-h periods, at week 32 of gestation, in preterm infants born between 28 and 32 weeks, hospitalized in the neonatal intensive care unit (NICU). The second aim is to assess postnatal changes in HRV measures between 32 and 35 weeks.

STUDY DESIGN

32 preterm infants born between 28 and 32 weeks of gestation were recruited. For each infant 48 h of recordings of RR interval were performed at week 32 and week 35. HRV parameters included time and frequency parameters.

RESULTS

At week 32, the intra-class correlation coefficient (ICC) of all HRV values was statistically significant with high correlation coefficients (ICC = 0.83-0.97). At week 35, a significant increase was noted in the HRV parameters, characterize mainly the sympathetic tone, with over half the infants showing an increase greater than the MDC for these parameters.

CONCLUSIONS

Using 24-h recording at week 32 of gestation during NICU routine is reliable, feasible, not costly and may have important implications for an early identification of premature in a state of stress such as sepsis, or as a follow-up measure.

摘要

目的

确定在 32 孕周的早产儿在出生后第 32 周至 35 周之间,在新生儿重症监护病房(NICU)住院期间,连续两个 24 小时期间的心率变异性(HRV)测量的可重复性和最小可检测变化(MDC)。第二个目的是评估 HRV 测量值在 32 周至 35 周之间的变化。

研究设计

招募了 32 名胎龄在 28 至 32 周之间的早产儿。对于每个婴儿,在第 32 周和第 35 周进行了 48 小时的 RR 间隔记录。HRV 参数包括时间和频率参数。

结果

在第 32 周时,所有 HRV 值的组内相关系数(ICC)均具有统计学意义,且相关性较高(ICC=0.83-0.97)。在第 35 周时,HRV 参数显著增加,主要表现为交感神经张力增加,超过一半的婴儿的这些参数增加超过 MDC。

结论

在 NICU 常规情况下,在 32 孕周时进行 24 小时记录是可靠、可行、经济且可能具有重要意义的,可以早期识别出处于应激状态的早产儿,如败血症,或作为后续措施。

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