Mullaart R A, Daniëls O, Hopman J C, de Haan A F, Stoelinga G B, Rotteveel J J
Paediatric Division, University Hospital, Nijmegen, The Netherlands.
Pediatr Neurol. 1995 Nov;13(4):319-22. doi: 10.1016/0887-8994(95)00193-x.
The purpose of this study was to investigate whether the preference of periventricular hemorrhage (PVH) for the left hemisphere is due to asymmetry of cerebral blood flow (CBF) and, if so, whether this asymmetry is due to patent ductus arteriosus (PDA). Thirty-three preterm newborns at risk for PVH were followed during their first 5 days after birth. Internal carotid CBF velocity (CBFV) and the flow direction in the common pulmonary artery, both determined by ultrasound Doppler, served as measures of CBF and PDA, respectively. The difference between right and left CBFV was analyzed statistically, with outcome, PDA, capillary PCO2, behavior, heart rate, and the average of right and left CBFV as covariates. Infants who developed PVH (n = 7) exhibited CBFV asymmetry to the disadvantage of the left side. This finding was partially attributable to PDA. Without PVH there was no significant CBFV asymmetry. Because all hemorrhages were bilateral, a relationship with the side of the hemorrhage could not be explored. In conclusion, asymmetry of CBFV is not normal, but is associated with PVH and PDA.
本研究的目的是调查脑室周围出血（PVH）对左半球的偏好是否归因于脑血流量（CBF）的不对称性，如果是，这种不对称性是否归因于动脉导管未闭（PDA）。对33名有PVH风险的早产新生儿在出生后的前5天进行了跟踪观察。分别通过超声多普勒测定的颈内动脉CBF速度（CBFV）和肺动脉总干中的血流方向，作为CBF和PDA的测量指标。对左右CBFV之间的差异进行了统计学分析，将结局、PDA、毛细血管PCO2、行为、心率以及左右CBFV的平均值作为协变量。发生PVH的婴儿（n = 7）表现出CBFV不对称，左侧处于劣势。这一发现部分归因于PDA。未发生PVH的婴儿则没有明显的CBFV不对称。由于所有出血均为双侧性，因此无法探究与出血侧的关系。总之，CBFV不对称并非正常现象，而是与PVH和PDA相关。
