Wang H, Zhang Z
Obstetrics and Gynecology Hospital, Shanghai Medical University.
Zhonghua Fu Chan Ke Za Zhi. 1995 Jul;30(7):387-90.
To study the relationship between the resistance index (RI) of the anterior cerebral artery and hypoxic ischemic encephapathy (HIE) in neonates for the purpose of finding out a method of diagnosing and predicting HIE and its prognosis.
The anterior cerebral artery blood flow velocity waveform (aCAFV) of neonates was recorded by a continuous Doppler technique and RI value was measured. 230 observations on 67 cases of high risk neonates and 534 on 182 normal neonates were performed. The mean value of RI and its standard deviation in normal neonates chosen served as control. The relationship between the standardized incidence of abnormal RI of the anterior cerebral artery and HIE was studied in high risk neonates.
In normal neonates (control group), RI was 0.62 +/- 0.09, and was in positive correlation (r = 0.72, P < 0.05) with the days after birth. The normal aCAFV was a regular waveform. In high risk neonates, the standardized incidence of abnormal RI in the neonates most likely to be attacked by HIE (A group) was significantly higher than that in control group (P < 0.001), but there was no significant difference between the other babies (B group) and control group (P > 0.05). However, the standardized incidence of abnormal RI in the A group was also significantly higher than that in the B group (P < 0.001). In the cases who were severely attacked by HIE, the standardized incidence of irregular waveform was the highest. Furthermore, when irregular aCAFV waveform appears, the incidence of pernicious complication of HIE and mortality of neonates were significantly increased in all cases.
The abnormal RI value of anterior cerebral artery implies the existence of HIE in neonates. The prognosis is poor when irregular blood flow waveform appears.
研究新生儿大脑前动脉阻力指数（RI）与缺氧缺血性脑病（HIE）的关系，以探寻诊断及预测HIE及其预后的方法。
采用连续多普勒技术记录新生儿大脑前动脉血流速度波形（aCAFV）并测量RI值。对67例高危新生儿进行了230次观察，对182例正常新生儿进行了534次观察。选取正常新生儿的RI平均值及其标准差作为对照。研究高危新生儿大脑前动脉RI异常的标准化发生率与HIE的关系。
正常新生儿（对照组）RI为0.62±0.09，与出生后天数呈正相关（r = 0.72，P < 0.05）。正常aCAFV为规则波形。在高危新生儿中，最易患HIE的新生儿（A组）RI异常的标准化发生率显著高于对照组（P < 0.001），但其他婴儿（B组）与对照组之间无显著差异（P > 0.05）。然而，A组RI异常的标准化发生率也显著高于B组（P < 0.001）。在HIE重度患儿中，不规则波形的标准化发生率最高。此外，当出现不规则aCAFV波形时，所有病例中HIE的严重并发症发生率及新生儿死亡率均显著增加。
大脑前动脉RI值异常提示新生儿存在HIE。出现不规则血流波形时预后不良。
