Lou H C, Lassen N A, Friis-Hansen B
Lancet. 1979 Jun 9;1(8128):1215-7. doi: 10.1016/s0140-6736(79)91898-1.
Computerised tomography has revealed that more than 40% of premature neonates (birth weight smaller than 1500 g) have cerebral bleeds in the first 3 or 4 days of extrauterine life. Injection studies done at necropsy have shown that they usually originate in the capillaries of the germinal matrix. It is suggested that premature neonates are hypertensive when their blood-pressure is compared with that in utero, and that events that lead to further rises in pressure are common. Their capillaries are not protected against rises in arterial pressure because autoregulation is impaired. Furthermore, the capillaries in the germinal matrix are not supported by firm glial structures. Arterial pressure rises are therefore likely to be responsible for germinal matrix haemorrhage in the premature neonate, and the risk of haemorrhage probably diminishes as autoregulation of cerebral blood-flow is restored a few days after birth.
计算机断层扫描显示，超过40%的早产儿（出生体重小于1500克）在宫外生活的头3或4天内发生脑内出血。尸检时进行的注射研究表明，这些出血通常起源于生发基质的毛细血管。有人提出，与子宫内相比，早产儿的血压较高，而且导致血压进一步升高的情况很常见。由于自身调节功能受损，他们的毛细血管无法抵御动脉压的升高。此外，生发基质中的毛细血管没有坚实的神经胶质结构的支撑。因此，动脉压升高很可能是导致早产儿生发基质出血的原因，而且随着出生后几天脑血流自身调节功能的恢复，出血风险可能会降低。
