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目的:探讨高胆红素血症与新生儿脑血流动力学指标的相关性。方法:选取95例高胆红素血症新生儿为观察组,另外选取50例正常健康新生儿为对照组,对比两组脑血流动力学指标的差异。结果:与对照组相比,观察组患儿舒张末期血流速度(Vd)、收缩期峰值流速(Vs)、时间平均流速(Vm)显著增加,而阻力指数(RI)、搏动指数(PI)显著减少(P<0.05)。其中高胆红素血症重度组Vd、Vs、Vm显著高于中、轻度组(P<0.05),而RI、PI则显著低于中、轻度组(P<0.05),中度组Vd、Vs、Vm显著高于轻度组(P<0.05),而RI、PI则显著低于轻度组(P<0.05)。随着患儿病情转归,高胆红素血症Vd、Vs、Vm、显著下降,而RI、PI显著上升,于治疗后第5天恢复至正常水平。经Person’s相关因素分析可知,血胆红素水平与Vd、Vs、Vm呈正相关,而与RI、PI呈负相关。结论:高胆红血症可引起新生儿脑血流动力学指标紊乱,脑血流动力学指标与胆红素水平关系密切,可作为新生儿高胆红素血症病情进展及预后的评价指标。
Objective: To investigate the correlation between hyperbilirubinemia and neonatal cerebral hemodynamics. Methods: Ninety-five neonates with hyperbilirubinemia were selected as the observation group. Fifty normal healthy newborns were selected as the control group, and the differences of cerebral hemodynamic parameters between the two groups were compared. Results: Compared with the control group, the end-diastolic velocity (Vd), the peak systolic velocity (Vs) and the mean velocity (Vm) increased significantly in the observation group, while the RI, PI, Significantly reduced (P <0.05). The levels of Vd, Vs and Vm in severe hyperbilirubinemia group were significantly higher than those in moderate and mild groups (P <0.05), but RI and PI were significantly lower than those in moderate and mild groups (P <0.05) Vd, Vs and Vm were significantly higher than those in mild group (P <0.05), but RI and PI were significantly lower than those in mild group (P <0.05). With the prognosis of children, Vd, Vs, Vm of hyperbilirubinemia decreased significantly, while RI, PI increased significantly, returned to normal level on the fifth day after treatment. Person’s related factors analysis showed that the level of serum bilirubin was positively correlated with Vd, Vs and Vm, but negatively correlated with RI and PI. Conclusion: Hypercholesterolemia can cause disorder of cerebral hemodynamics in neonates, and the indexes of cerebral hemodynamics are closely related to the level of bilirubin, which can be used as evaluation index of the progression and prognosis of neonatal hyperbilirubinemia .