Gingras J L, Muelenaer A, Dalley L B, O'Donnell K J
Department of Pediatrics, Duke University Medical Center, Durham, North Carolina 27710.
Pediatr Pulmonol. 1994 Jul;18(1):13-20. doi: 10.1002/ppul.1950180106.
To test the hypothesis that respiratory control is altered in cocaine-exposed infants, we evaluated the hypoxic arousal response and the ventilatory response to carbon dioxide (CO2) in 18 term newborn infants prenatally exposed to cocaine and in 10 healthy, term newborn infants within the first week of life. Three infants could not be tested for the hypoxic arousal response because of low baseline oxygen saturation, and data from these infants were excluded from analysis. Twelve hour overnight pneumocardiograms were performed on all infants. Results show that 60% (9/15) of the prenatally cocaine-exposed infants had an abnormal hypoxic arousal response and 87% (13/15) had abnormal hypercarbic ventilatory response. Only 6% (1/15) of the prenatally cocaine-exposed infants demonstrated any abnormality on pneumocardiogram. In contrast, all control infants (10/10) were aroused by the hypoxic challenge and 80% (8/10) had normal ventilatory response to CO2. No abnormalities were found in the assessment of the overnight pneumocardiogram in the control infants. For the cocaine-exposed infants, test abnormalities were not correlated with a concurrent positive urine toxicology for cocaine, suggesting that the injury occurs early in development. These findings support the hypothesis that infants prenatally exposed to cocaine demonstrate abnormalities of respiratory control.
为了验证可卡因暴露婴儿的呼吸控制发生改变这一假设，我们在出生后第一周内，对18名产前暴露于可卡因的足月儿和10名健康足月儿的低氧唤醒反应及对二氧化碳（CO₂）的通气反应进行了评估。由于基线血氧饱和度低，有3名婴儿无法进行低氧唤醒反应测试，这些婴儿的数据被排除在分析之外。所有婴儿均进行了12小时的夜间肺心动图检查。结果显示，60%（9/15）的产前暴露于可卡因的婴儿存在异常低氧唤醒反应，87%（13/15）存在异常高碳酸通气反应。产前暴露于可卡因的婴儿中只有6%（1/15）在肺心动图上显示出任何异常。相比之下，所有对照婴儿（10/10）在低氧刺激下都有唤醒反应，80%（8/10）对CO₂有正常通气反应。对照婴儿的夜间肺心动图评估未发现异常。对于暴露于可卡因的婴儿，测试异常与可卡因尿液毒理学检测阳性无相关性，这表明损伤发生在发育早期。这些发现支持了产前暴露于可卡因的婴儿存在呼吸控制异常这一假设。
