Mullaart R A, Hopman J C, Rotteveel J J, Daniëls O, Stoelinga G B, De Haan A F
Paediatric Division, University Hospital Nijmegen, Netherlands.
Early Hum Dev. 1994 Jun;37(3):179-85. doi: 10.1016/0378-3782(94)90077-9.
The relationship of cerebral blood flow fluctuation (CBFF) with periventricular haemorrhage (PVH) and respiratory distress syndrome (RDS) was studied in 35 preterm newborns. CBFF was defined as the interquartile range in the ensemble of pulses of a 20-s Doppler recording of CBF velocity (CBFV) in the internal carotid artery. We found a statistically significant increase in end diastolic CBFF in PVH and RDS. This increase was related to the mode of respiration (spontaneous or mechanically supported), the state of the ductus arteriosus, and the level of end diastolic CBFV. Differences before and after the onset of PVH were not found. In view of this, we conclude that RDS increases CBFF, that this increase is related to pleural pressure fluctuations, that these can be damped by mechanical ventilation, and that their propagation to the CBF is promoted by patency of the ductus arteriosus and foramen ovale. Whether the CBFF increase causes PVH, or is merely an expression of coincident RDS, remains a question that needs further investigation.
在35例早产新生儿中研究了脑血流波动（CBFF）与脑室周围出血（PVH）及呼吸窘迫综合征（RDS）之间的关系。CBFF定义为颈内动脉脑血流速度（CBFV）20秒多普勒记录的脉冲集合中的四分位数间距。我们发现PVH和RDS患儿舒张末期CBFF有统计学意义的增加。这种增加与呼吸模式（自主呼吸或机械通气支持）、动脉导管状态以及舒张末期CBFV水平有关。未发现PVH发作前后的差异。鉴于此，我们得出结论，RDS会增加CBFF，这种增加与胸膜压力波动有关，机械通气可抑制这些波动，动脉导管和卵圆孔未闭会促进其向脑血流的传播。CBFF增加是导致PVH，还是仅仅是RDS同时出现的一种表现，仍是一个需要进一步研究的问题。
