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目的 探讨心功能改变对早产儿早期脑血流的影响.方法 2007年1-7月在暨南大学第二附属医院深圳市人民医院新生儿科住院的261例胎龄为29～36+6周的早产儿于生后不同日龄根据左心室射血分数(EF)各分为3组.应用经颅多普勒监测早产儿生后1、3、7 d的大脑中动脉血流速度指标及血管弹性指标.应用彩色多普勒超声心动图监测早产儿心功能指标及主动脉瓣口峰值流速.记录生后1 d早产儿胎龄及出生体重,并监测体温、血气、血糖、血压及红细胞比积.结果 生后1、3、7 d早产儿的脑血流速度均随EF增加而加快;EF与大脑中动脉收缩期峰值流速、舒张期末血流速度、平均血流速度均呈正相关(r分别为0.70、0.41、0.61,P均<0.01),而EF与血管阻力指数及弹性指数未见明显相关性.结论 早产儿早期脑血流速度受左室泵血功能的影响,而胎龄及出生体重是影响早产儿早期左室泵血功能的重要因素.

Influence of cardiac function on the cerebral blood flow in preterm infants

??Objective??To investigate the influence of cardiac function on the cerebral blood flow in preterm infants. Methods??From January 2007 to July 2007 in our hospital Neonatal Department??261 preterm infants aged from 29 w to 36+6 w were divided into 3 groups according to left ventricular ejection fraction??EF??. The index of blood flow rate and blood vessel elasticity of arteria cerebri media were monitored by transcranial Doppler on the first day??the third day and the seventh day??cardiac pumping function and peak flow rate of aorta valve orifice were monitored by the color Doppler echocardiography in the preterm infants??meanwhile??the temperature??blood gas??blood glucose??blood pressure and hematocrit were monitored on the first day in the preterm infants??their gestational age and birth weight being recorded. Results??The cerebral blood flow gradually increased with left ventricular EF. There were positive correlation between EF and systolic peak velocity??diastolic velocity and mean velocity of arteria cerebri media??r was 0.70??0.41??0.61 respectively??P <0.01????while there was no significant correlation between EF and resistent index or elasticity index. Conclusion??The velocity of cerebral blood flow is influenced by left ventricular function in the preterm infants??gestational age and birth weight are important factors influencing left ventricular function.