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浙江大学学报(医学版)  2016, Vol. 45 Issue (3): 287-291    DOI: 10.3785/j.issn.1008-9292.2016.05.10
原著     
血流动力学改变对动脉导管未闭早产儿脑白质损伤发生的影响
陆俊秀1, 杨冰岩1, 陈敬国2, 徐焕丽3, 陈海燕2
1. 南方医科大学附属中山市博爱医院新生儿科, 广东 中山 528400;
2. 中山大学附属中山医院新生儿科, 广东 中山 528403;
3. 深圳市儿童医院新生儿科, 广东 深圳 518000
Effect of cerebral hemodynamic changes on white matter damage in premature infant with patent ductus arteriosus
LU Junxiu1, YANG Bingyan1, CHEN Jingguo2, XU Huanli3, CHEN Haiyan2
1. Department of Neonate, BOAI Hospital of Zhongshan Affiliated to Southern Medical University, Zhonshan 528400, China;
2. Department of Neonate, Zhongshan People's Hospital Affiliated to Sun Yat-sen University, Zhonshan 528403, China;
3. Department of Neonate, Shenzhen Children's Hospital, Shenzhen 518000, China
全文: PDF(1034 KB)  
摘要: 

目的:探讨血流动力学改变对动脉导管未闭(PDA)早产儿脑白质损伤发生的影响。方法:具有血流动力学改变的PDA早产儿35例(hsPDA组)、没有血流动力学改变的PDA早产儿35例(非hsPDA组)、非PDA早产儿36例(对照组)分别于出生后3 d、7 d、14 d检测血清神经特异性烯醇化酶(NSE)的水平,同时进行颅脑超声显像检查,作超声心动图显像PDA血流速度与颅脑超声显像侧脑室灰度值相关性分析。结果:出生后3 d、7 d、14 d颅脑超声显像侧脑室灰度值hsPDA组均高于对照组(均P<0.01),非hsPDA组与对照组差异均无统计学意义(均P>0.05);出生后3 d、7 d、14 d血清NSE水平hsPDA组均高于对照组(均P<0.01),非hsPDA组与对照组差异均无统计学意义(均P>0.05)。早产儿PDA血流速度大小与超声显像侧脑室灰度值呈正相关(r=0.876,P<0.01)。结论:hsPDA早产儿容易发生脑白质损伤,需要及时干预。

关键词 血流动力学动脉导管未闭/病理生理学磷酸丙酮酸水合酶/血液神经元/酶学白质软化病,脑室周围/病理学脑损伤/病理学婴儿,早产    
Abstract

Objective: To investigate the effect of cerebral hemodynamic changes on white matter damage in premature infant with patent ductus arteriosus(PDA). Methods: A total of 106 premature infants were enrolled in the study, including 35 PDA infants with hemodynamic changes (hsPDA group), 35 PDA infants without hemodynamic changes (non-hsPDA group) and 36 non-PDA infants (control group). Serum level of neuron-specific enolase (NES) was detected and craniocerebral ultrasound examination was performed on d3, d7 and d14 after birth. The correlation between blood flow rate of PDA and gray scale value of lateral ventricle was analyzed. Results: Gray scale values of lateral ventricle and serum levels of NES in hsPDA group were higher than those in control group on d3, d7 and d14 (P<0.01), but no significant difference was observed between non-hsPDA group and control group (P>0.05). There was a positive correlation between the blood flow rate of PDA and gray scale value of lateral ventricle (r=0.876, P<0.01) in premature infants. Conclusion: Patent ductus arteriosus with hemodynamic changes is closely related to white matter damage in premature infants, and early intervention is necessary.

Key wordsHemodynamics    Ductus arteriosus, patent/physiopathology    Phosphopyruvate hydratase/blood    Neurons/enzymology    Leukomalacia, periventricular/pathology    Brain injuries/pathology    Infant, premature
收稿日期: 2016-01-15
CLC:  R4  
基金资助:

2013年中山市医学科研项目(2013a020050)

通讯作者: 杨冰岩(1963-),男,学士,主任医师,主要从事新生儿及小儿急救研究;E-mail:ybyicu@126.com;http://orcid.orgorcid.org/0000-0002-6022-6605     E-mail: ybyicu@126.com
作者简介: 陆俊秀(1983-),女,硕士研究生,主治医师,主要从事新生儿神经系统疾病研究;E-mail:lujunxiu2011@163.com;http://orcid.org/0000-0001-6591-6982
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引用本文:

陆俊秀 等. 血流动力学改变对动脉导管未闭早产儿脑白质损伤发生的影响[J]. 浙江大学学报(医学版), 2016, 45(3): 287-291.
LU Junxiu, YANG Bingyan, CHEN Jingguo, XU Huanli, CHEN Haiyan. Effect of cerebral hemodynamic changes on white matter damage in premature infant with patent ductus arteriosus. Journal of ZheJiang University(Medical Science), 2016, 45(3): 287-291.

链接本文:

http://www.zjujournals.com/xueshu/med/CN/10.3785/j.issn.1008-9292.2016.05.10      或      http://www.zjujournals.com/xueshu/med/CN/Y2016/V45/I3/287

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