超声多普勒评价早产儿豆纹动脉血流动力学变化规律

Doppler ultrasonographic assessment of hemodynamics regularity of lenticulostriate artery in preterm infants

目的了解早产儿出生1周内豆纹动脉(LSA)的血流动力学变化规律及影响因素。方法应用多普勒超声,于出生后1(1天组)、3(3天组)、7天(7天组)动态检测293名早产儿的LSA血流参数,分别测量收缩期峰值流速(Vs)、舒张末期速度(Vd)、平均血流速度(Vm)、收缩期峰值流速与舒张末期速度的比值(S/D)、阻力指数(RI)、搏动指数(PI)。结果早产儿LSA血流速度参数均随日龄增加而升高,其中Vd、Vm上升趋势最明显(P均<0.05)。不同日龄早产儿LSA的S/D比较,S/D在出生后第3天最低,7天组明显高于3天组,差异有统计学意义(P<0.05);不同日龄早产儿RI、PI比较,组间差异均无统计学意义(P均>0.05)。早产儿LSA的Vs、Vd、Vm与胎龄、出生时体质量呈正相关(r=0.36、0.38、0.37;0.30、0.26、0.30,P均<0.05)。结论超声多普勒检测早产儿豆纹动脉可反映早产儿局部脑实质血流动力学改变,并可用以评价脑基底节区损伤的血流动力学变化规律。

Objective To observe the hemodynamic changes and influencing factors of lenticulostriate artery（LSA） in preterm infants during first week after birth.Methods Two hundred and ninety-three preterm infants underwent Doppler ultrasonography 1（1 day group）,3（3 days group）,7 days（7 days group） after the birth.Peak systolic velocity（Vs）,end diastolic velocity（Vd）,mean peak velocity（Vm）,the ratio between Vs and Vd（S/D）,resistance index（RI） and pulsatility index（PI） of LSA were measured.Results The blood velocity of LSA gradually increased with aging,while the upward tendency of Vd and Vm were obvious（all P〈0.05）.S/D in 3 days group was the lowest,and was significantly lower than that of 7 days group（P〈0.05）.Both RI and PI in different aging preterm infants were compared,the difference in 3 groups were not obvious（all P〈0.05）.The Vs,Vd,Vm were positive correlated with gestational weeks and birth weight in preterm infants（r=0.36,0.38,0.37;0.30,0.26,0.30,all P〈0.05）.Conclusion Doppler ultrasonographic assessment of LSA in preterm infants can reflect hemodynamicc changes in part brain tissue,therefore evaluate hemodynamics regularity in the impaired basal ganglia.