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健康足月新生儿出生后最早阶段的皮肤电活动与交感神经系统活动和疼痛相关反应。

Sympathetic nervous system activity and pain-related response indexed by electrodermal activity during the earliest postnatal life in healthy term neonates.

机构信息

Department of Neonatology, University Hospital in Martin and Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovak Republic.

出版信息

Physiol Res. 2023 Jul 14;72(3):393-401. doi: 10.33549/physiolres.935061.

Abstract

Sympathetic nervous system (SNS) undergoes a prolonged period of fetal and neonatal development and maturation during which is vulnerable to a variety of influences (e.g. painful experiences). Thus, we aimed to evaluate SNS activity at rest and in response to stressful stimulus (pain) within the earliest postnatal life in healthy term neonates using electrodermal activity (EDA) measures. In twenty eutrophic healthy term neonates EDA was recorded within the first two hours after birth (measurement 1 - M1) and 72 h after birth (measurement 2 - M2) at rest and in response to pain (M1 - intramuscular K vitamin administration; M2 - heel stick). Evaluated parameters were skin conductance level (SCL), non-specific skin conductance responses (NS.SCRs), skin SCL 10 s before pain stimulus (SCL_10 before pain), skin conductance response (SCR) peak after pain stimulus, SCL 10 s after pain stimulus (SCL_10 after pain), SCR magnitude, latency, SCR rise/decline time, SCR half recovery time. SCL was significantly decreased at rest during M2 compared to M1 (p=0.010). SCL_10 before pain, SCR peak after pain, and SCL_10 after pain stimulus were significantly decreased in M2 compared to M1 (p=0.014, p=0.020, p=0.011, respectively). SCL was significantly decreased and NS.SCRs were significantly higher in the recovery period after the pain stimulus during M2 compared to M1 (p=0.015, p=0.032, respectively). Our results indicate EDA parameters sensitive to detect sympathetic changes during the earliest postnatal life reflecting its potential in early diagnosis of the autonomic maturation - linked pathological states in neonates.

摘要

交感神经系统(SNS)在胎儿和新生儿期经历了一个漫长的发育和成熟过程,在此期间,它容易受到各种影响(例如,痛苦的经历)。因此,我们旨在使用皮肤电活动(EDA)测量来评估健康足月新生儿在最早的产后生活中静息时和对应激刺激(疼痛)的 SNS 活动。在 20 名营养良好的足月新生儿中,在出生后前两小时(测量 1-M1)和出生后 72 小时(测量 2-M2)时,在静息状态下和疼痛反应时(M1-肌肉内 K 维生素给药;M2-足跟采血)记录 EDA。评估的参数包括皮肤电导水平(SCL)、非特异性皮肤电导反应(NS.SCRs)、疼痛刺激前 10 秒的皮肤 SCL(SCL_10 前疼痛)、疼痛刺激后的皮肤电导反应(SCR)峰值、疼痛刺激后 10 秒的皮肤 SCL(SCL_10 后疼痛)、SCR 幅度、潜伏期、SCR 上升/下降时间、SCR 半恢复时间。与 M1 相比,M2 时静息状态下 SCL 显著降低(p=0.010)。与 M1 相比,M2 时 SCL_10 前疼痛、疼痛刺激后的 SCR 峰值和 SCL_10 后疼痛刺激均显著降低(p=0.014、p=0.020、p=0.011)。与 M1 相比,M2 时疼痛刺激后的恢复期 SCL 显著降低,NS.SCRs 显著升高(p=0.015、p=0.032)。我们的结果表明,EDA 参数对检测最早产后生命中交感神经变化敏感,反映了其在新生儿自主神经成熟相关病理状态的早期诊断中的潜力。

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