高频彩超结合E-flow显像对早产儿早期脑血流灌注特点的观察

Observation of cerebral blood flow infusion in early preterm infants by high-frequency color Doppler combined with E-flow

目的:探讨早产儿出生早期脑组织血流灌注特点。方法:应用高频超声结合E-flow血流显像技术,对体质量≥1 500 g早产儿(早产儿A组)35例、出生体质量<1 500 g(早产儿B组)33例、足月新生儿35例进行研究,在生后72小时内检测大脑中动脉(Middle cerebral artery,MAC)、豆纹动脉(Lenticulostriate artery,LSA)、豆纹动脉终末段(The terminal artery of lenticulostriate artery,LSAt)的血流参数,包括收缩期峰值流速(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)。采用t检验比较各组间的差别。结果:早产儿A组MCA的Vs、Vd、Vm测值低于足月新生儿(P<0.05),且早产儿B组MCA的Vs、Vm低于早产儿A组(P<0.05);S/D、RI三组间比较无统计学差异(P>0.05)。早产儿A组的LSA、LSAt的血流参数Vs、Vd、Vm、S/D及RI均比足月儿组明显减低(P<0.01,P<0.05),且早产儿B组除S/D外,其余测值均低于早产儿A组(P<0.01)。结论:高频超声结合E-flow显像技术对脑实质内细小血管的血流参数进行检测,可更敏感地反映早产儿早期脑实质血流灌注的基础状态,为临床判断早产儿脑损伤时血流动力学变化提供依据。

Objective: To observe the feature of cerebral blood flow infusion in early preterm infants. Methods: The Vs,Vd, Vm, S/D and RI were recorded in 68 preterm infants(group A: weight≥1 500 g, group B: weight<1 500 g) and 35 healthy term neonates. The measurement above middle cerebral artery(MCA), lenticulostriate artery(LSA), the terminal artery of lenticulostriate artery(LSAt) was performed by high-frequency color Doppler ultrasound and E-flow within 72 hours after birth. Result: The Vs, Vd, Vm of MCA in preterm infants were lower than that in healthy term neonates obviously(all P<0.05), and the Vs, Vm of MCA of group B were lower than group A, too; while S/D and RI of MCA were not different among the three groups(P>0.05). The Vs, Vd, Vm, S/D and RI of LSA and LSAt in preterm infants were all lower than that in healthy term neonates(P <0.01). And all the parameters of group B were lower than group A except S/D. Conclusion: The monitoring of multistage brain blood vessel by high-frequency color Doppler combined with E-flow can reflect the basic cerebral blood flow infusion more sensitively and it is valuable to predict the change of cerebral blood flow dynamic in the brain damage of preterm infants.