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目的探讨新生儿早期脑血流随日龄的动态变化。方法选择本院新生儿科住院的早产适于胎龄儿和健康足月儿,应用经颅多普勒超声测定不同胎龄新生儿生后7d内每天大脑中动脉(MAC)血流速度及阻力指数(RI)和搏动指数(PI)。结果早产适于胎龄儿组65例,足月儿组49例。足月儿组脑血流速度较早产儿组明显增快(P<0.05);各组2～7d各时间段大脑中动脉收缩期峰值流速(Vs)、平均血流速度(Vm)、舒张期末血流速度(Vd)均较第1天增快(P<0.05);早产适于胎龄儿组3～7d各时间段Vs、4～7d各时间段Vm与第2天比较均增快(P<0.05);足月儿组4～7d各时间段Vs和Vm均较第2天增快(P<0.05);早产适于胎龄儿与足月儿Vs、Vm4～7d各时间段呈逐渐增加趋势,但差异无统计学意义;Vd增加较缓慢,2～7d各时间段差异不明显;新生儿早期RI、PI亦呈渐增趋势,生后第1天较高,2～7d内RI、PI短时期降低之后RI、PI又逐渐升高。结论新生儿早期脑血流速度随日龄增大逐渐增快,生后前3d波动较大,然后缓慢增加,逐渐趋于稳定。
Objective To investigate the dynamic changes of early cerebral blood flow with age. Methods The hospitalized neonates in our hospital were selected for gestational age and healthy term infants. The daily middle cerebral artery (MAC) blood flow velocity and resistance index were measured by transcranial Doppler echocardiography within 7 days after birth. (RI) and pulsatility index (PI). Results Preterm birth was suitable for 65 cases of gestational age children, 49 cases of full-term children. Cerebral blood flow velocity of full-term infants was significantly higher than that of premature infants (P <0.05). Peak systolic velocity (Vs), mean velocity of blood flow (Vm), end diastolic velocity Blood flow velocity (Vd) increased faster than that on the first day (P <0.05); Vs for preterm labor in gestational age group at 3 ~ 7d and Vm increased at 4 ~ 7d P <0.05). The Vs and Vm of full-term infants increased significantly from 4 days to 7 days (P <0.05) than those from the second day (P <0.05) But the difference was not statistically significant. The increase of Vd was relatively slow, but the difference was not obvious between 2 and 7 days. The RI and PI of the newborn increased gradually, the first day after birth was higher and within 2 ~ 7 days RI, PI after a short period of reduced RI, PI and then gradually increased. Conclusions The rate of cerebral blood flow in early neonates gradually increases with the increase of age, and fluctuates greatly in the first three days after birth, then increases slowly and gradually becomes stable.