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[早产儿和足月儿睡眠及自主神经系统控制的发育]

[Development of the sleep and autonomic nervous system control in premature and full-term newborn infants].

作者信息

Curzi-Dascalova L

机构信息

INSERM, laboratoire de physiologie-EFR, hôpital Antoine-Béclère, Clamart, France.

出版信息

Arch Pediatr. 1995 Mar;2(3):255-62. doi: 10.1016/0929-693x(96)81138-9.

Abstract

Well defined periods of active (AS) and quiet sleep (QS) are detected as early as 27 weeks gestational age (w GA). Beyond 35 w GA, the amount of indeterminate sleep is reduced to < 10% and, up to the normal term, sleep is marked by the prevalence of AS. AS differs from QS by faster respiratory and heart rates, more central respiratory pauses, lower amplitude of high frequency heart rate variability (parasympathetico-dependent) and higher amplitude of low frequency heart rate variability (sympathetico-dependent). In artificially ventilated infants, breathing is more dependent on the ventilator in QS than in AS. When they reach term, compared with normal full-term newborns, infants with intra-uterine growth retardation or prematurity do not show significant differences of sleep structure, but present in both AS and QS, faster heart and respiratory rates, more respiratory pauses and less heart rate variability; however, sleep-states-related cardio-respiratory modulations appear similar.

摘要

早在孕27周时就能检测到明确的主动睡眠(AS)期和安静睡眠(QS)期。孕35周后,不确定睡眠量减少至<10%,直至足月,睡眠以主动睡眠为主。主动睡眠与安静睡眠的区别在于呼吸和心率更快、中枢性呼吸暂停更多、高频心率变异性(副交感神经依赖性)幅度更低以及低频心率变异性(交感神经依赖性)幅度更高。在人工通气的婴儿中,安静睡眠时呼吸比主动睡眠时更依赖呼吸机。足月时,与正常足月新生儿相比,宫内生长受限或早产的婴儿睡眠结构无显著差异,但在主动睡眠和安静睡眠中均表现出更快的心率和呼吸频率、更多的呼吸暂停以及更小的心率变异性;然而,与睡眠状态相关的心肺调节似乎相似。

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