Perlman J M, Hill A, Volpe J J
J Pediatr. 1981 Nov;99(5):767-71. doi: 10.1016/s0022-3476(81)80408-8.
Marked changes in blood flow velocity in the anterior cerebral arteries, measured by a Doppler technique, have been related to PDA in premature infants. Thus, 55 premature infants of birth weight less than 2,000 gm were studied. Ten developed PDA between days three and ten of life. A sharp decrease in diastolic flow velocity and an increase in pulse amplitude in the ACA was observed with the occurrence of PDA. Return of these values to normal occurred promptly following closure of the lesion. These changes in flow velocity and pulse amplitude in the ACA appear to be determined principally by changes in systemic diastolic pressure which accompany PDA. There was no consistent relationship between the changes in flow velocity and arterial PCO2 values. These data suggest that PDA may be involved in the genesis of ischemic and hemorrhagic cerebral injury in the premature newborn infant. Thus, the decrease in flow velocity appears to represent a "steal" of blood from the cerebral arteries, analogous to other documented steal phenomena observed in older patients. Major fluctuations of blood flow velocity in the ACA, with opening and closure of the PDA, and the increase in amplitude of each pulse with PDA may, in the presence of disturbed autoregulation, cause rupture of the capillaries of the germinal matrix and thus, IVH.
通过多普勒技术测量发现，前脑动脉血流速度的显著变化与早产儿的动脉导管未闭（PDA）有关。因此，对55名出生体重小于2000克的早产儿进行了研究。其中10名在出生后第3天至第10天发生了PDA。随着PDA的出现，观察到前脑动脉舒张期血流速度急剧下降，脉搏振幅增加。病变闭合后，这些值迅速恢复正常。前脑动脉血流速度和脉搏振幅的这些变化似乎主要由PDA伴随的体循环舒张压变化所决定。血流速度变化与动脉血二氧化碳分压值之间没有一致的关系。这些数据表明，PDA可能参与了早产新生儿缺血性和出血性脑损伤的发生。因此，血流速度的下降似乎代表了从脑动脉“窃取”血液，类似于在老年患者中观察到的其他已记录的盗血现象。在自动调节功能紊乱的情况下，随着PDA的开放和闭合，前脑动脉血流速度的主要波动以及PDA时每个脉搏振幅的增加，可能导致生发基质的毛细血管破裂，从而导致脑室内出血（IVH）。
