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通过对早产儿脑血流及平均动脉压变化水平进行监测,了解早产儿的脑血流自主调节功能,探讨受损的脑血流自主调节与脑损伤的关系,对55例早产儿按胎龄分为早产Ⅰ组20例(胎龄<32周)和早产Ⅱ组35例(胎龄>32周)。所有病例均在生后72小时内开始床旁近红外光谱仪(Near-Infrared Spectroscopy,NIRS)及平均动脉压(mean arterial blood pressure,MABP)的监测来判断脑血流自主调节功能;并对所有病例进行头颅B超,随访以判定脑损伤。结果:胎龄<32周20例早产儿中有9例自主调节功能受损(9/20,45％),胎龄≥32周35例早产儿中仅3例自主调节功能受损(3/35,8.6％);有自主调节功能受损者33.3％随后发生严重脑损伤,明显高于自主调节功能良好者,P<0.01。结论:胎龄<32周早产儿易出现脑血流自主调节功能受损,受损的脑血流自主调节与随后严重脑损伤的发生关系密切。
By monitoring the changes of cerebral blood flow and mean arterial pressure in preterm infants, we can know the autonomic regulation of cerebral blood flow in premature infants and explore the relationship between autonomic regulation of impaired cerebral blood flow and brain injury. Divided into preterm group Ⅰ group of 20 cases (gestational age <32 weeks) and preterm group Ⅱ 35 cases (gestational age> 32 weeks). All cases were monitored by near-infrared spectroscopy (NIRS) and mean arterial blood pressure (MABP) within 72 hours after birth to determine the autonomic regulation of cerebral blood flow; and in all cases B-head skull, follow-up to determine brain damage. RESULTS: Nine of 20 preterm infants with gestational age <32 weeks had impaired autonomic dysfunction (9/20, 45%) and only 3 of 35 preterm infants with gestational age ≥32 weeks had impaired autonomic dysfunction (3 / 35,8.6%). 33.3% patients with autonomic dysfunction followed by severe brain injury were significantly higher than those with good autonomic function (P <0.01). Conclusion: Autonomic regulation of cerebral blood flow is easy to occur in preterm infants of gestational age <32 weeks. The impaired autonomic regulation of cerebral blood flow is closely related to the subsequent severe brain injury.