新生儿血压节律及窒息或早产因素对血压节律影响的研究

目的了解正常新生儿生后早期(48h内)血压是否存在昼夜节律变化规律,以及窒息或早产因素对血压节律的影响.方法对106例正常足月自然分娩新生儿、30例足月重度窒息儿(1分钟Apgar评分<3分)及28例早产儿于生后48h内的测量血压,选择生后2、6、10、14、18、22时为测量时间点.结果正常足月自然分娩新生儿生后早期各时间点血压值(包括收缩压、舒张压和平均动脉压,下同)差异有显著性 ( WTBX〗P均<0.05),表现为生后2时最低,6～10时升至最高,在14时有一低谷,在18 时又有一小高峰,至22时又下降.窒息组及早产组生后48h内各时间点血压值差异无显著性(窒息组 P分别为0.650、0.943和0.912,早产组P分别为0.283、0.575和0.327).结论正常足月自然分娩新生儿生后早期血压有昼夜节律变化,重度窒息儿及早产儿在生后早期未出现血压昼夜节律变化.

The meonatal blood pressure rhythm and the influence of asphyxia and pre maturity on it

ObjectiveTo find out the blood pressure(BP)circadian rhythm of normal and asphyxiated and preterm neonates in their first 48-hour life.MethodsOne hundred and six healthy full-term natural delivered neonates,30 asphyxiated neonates with Apgar score<3 at 1 minute and 28 preterms were enrolled.BP were measured respectively at 2,6,10,14,18,22 o'clock in 48 hours.ResultsIn healthy full-term natural delivered neonates,systolic BP(SBP)reached its nadir at 2 o'clock,elevated to the highest values at 6 o'clock to 10 o'clock,declined at 14 o'clock,then elevated again at 18 o'clock which was not as high as the values of morning,declined at 22 o'clock,to the lowest at 2 o'clock of the next day.There were significan difference in values among the six measuring points(P<0.05).The fluctuation of diastolic BP(DBP)and mean BP(MBP)was similar to SBP.SBP and DBP and MPB every measure point in the asphyxiated group had no difference(P=0.65,0.943,0.912 respectively).So did the preterm group.ConclusionHealthy full-term natural delivered neonates have BP circadian rhythm in their first 48-hour.Asphyxiated and preterm neonates have no circadian BP rhythm in their first 48-hour-life.