新生儿黄疸对心率变异性的影响及其临床意义

目的探讨新生儿黄疸对心率变异性的影响及其临床意义。方法应用美国威豪公司CompaxXMHolter分析系统检测12例轻-中度黄疸新生儿、8例重度黄疸新生儿治疗前后和12例正常新生儿的心率变异性。结果轻-中度黄疸患儿即显示有HRV的增高,表现为SNDD、SNDD index、RMSSD、5min total power、HF的升高(P<0.05),而重度黄疸HRV则下降,表现为SNDD、5min total power下降(P<0.05)。经治疗后重度黄疸的HRV增加,表现为交感神经张力的增加,但仍低于对照组(P<0.05)。结论新生儿黄疸可影响心脏自主神经功能,表现为交感神经张力增加。心率变异性判断新生儿黄疸预后的可靠指标。其中SNDDindex、5min total power两项指标反应黄疸新生儿的交感神经张力更敏感。

Influence of newborn jaundice on heart rate variability and its clinical significance

Objective To discuss the influence of newborn jaundice on heart rate variability (HRV) and its clinical significance.Methods HRV was explored by American Waltham's company Compax XM Holteranalysis System respectively in 12 newborn infants with mild-moderate jaundice and 8 newborn infants with severe jaundice before and after treatment,and in 12 normal newborn infants (controls) .Results HRV of the infants with mild-moderate jaundice was increased,increase in SNDD,SNDD index, RMSSD,5-min total power and HF rise (P<0.05) ,and that of those with severe jaundice declined,representing decrease in SNDD and 5-min total power (P<0.05) .The post-treatment HRV of those with severe jaundice went up with the signs of increased sympathetic tension,but still less than that of control group (P<0.05) .Conclusion Neonatal jaundice affects heart au-tonomic function with an increased sympathetic tension.HRV is the reliable indicator of judgment of neonatal jaundice.SNDD and 5-min total power are the two more sensitive indexes reflecting sympathetic tension in those with newborn jaundice.