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脑血流动力学改变与新生儿高胆红素血症的相关性分析
Association between cerebral hemodynamic changes and neonatal hyperbilirubinemia
文章发布日期:2017年09月07日  来源:  作者:刘书艳  点击次数:173次  下载次数:33次

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【摘要】:目的研究脑血流动力学指标的改变与新生儿高胆红素血症之间的相关性。方法选取安阳市妇幼保健院2014年1月-2015年11月收治的67例高胆红素血症患儿为研究对象,将其设为研究组;以同期36例正常健康新生儿为对照组。观察比较两组新生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)、阻力指数(RI)、搏动指数(PI) 等检测指标。治疗后,观察患儿血清胆红素水平及全身症状。计量资料组间比较采用t检验,相关性检验采用Pearson相关分析。结果治疗前和治疗第3天对照组Vd、Vs、Vm值均低于研究组,而RI、PI值均高于研究组,差异均有统计学意义(治疗前:t值分别为75873、81589、64600、19834、30453;治疗3 d:t值分别39476、55729、35274、6069、9382,P值均<0.001)。治疗第3天研究组患儿Vd、Vs、Vm、RI、PI 较入院当天治疗前均有所改善。治疗第5天两组患儿脑血流动力学指标与对照组比较,差异均无统计学意义(P值均>0.05)。血胆红素水平与Vd(r=0.387,P<0.001)、Vs (r=0.483,P<0.001)、Vm (r=0.412,P<0.001)呈正相关,而与RI(r=-0.492,P=0.001 )、PI (r=-0.497,P<0.001)呈负相关。结论胆红素水平与脑血流动力学两者相互影响,脑血流动力学指标可为新生儿高胆红素血症病情发展以及预后状态判断提供客观证据。
【Abstract】:ObjectiveTo investigate the association between cerebral hemodynamic changes and neonatal hyperbilirubinemia. MethodsA total of 67 neonates with hyperbilirubinemia who were admitted to our hospital from January 2014 to November 2015 were enrolled as study group, and another 36 normal healthy neonates were enrolled as control group. The two groups were compared in terms of end-diastolic velocity (Vd), systolic peak velocity (Vs), mean blood flow velocity (Vm), resistance index (RI), and pulsatility index (PI), and the serum level of bilirubin and systemic symptoms were observed after treatment. The t-test was used for comparison of continuous data between groups, and a Pearson correlation analysis was also performed. ResultsAt the time of enrolment and on day 3 of treatment, the control group had significantly lower Vd, Vs, and Vm than the study group (before treatment: t=75873,81589,64600,19834,30453; day 3 of treatment: t=39476,55729,35274,6069,9382, all P<0.001). The study group had improvements in Vd, Vs, Vm, RI, and PI on day 3 of treatment. On day 5 of treatment, there were no significant differences in hemodynamic parameters between the two groups (all P>0.05). Serum level of bilirubin was positively correlated with Vd (r=0.387, P<0.001), Vs (r=0.483, P<0.001), and Vm (r=0.412, P<0.001) and negatively correlated with RI (r=-0.492, P<0.001) and PI (r=-0.497, P<0.001). ConclusionSerum level of bilirubin interacts with cerebral hemodynamics, and cerebral hemodynamic parameters can provide objective evidence for evaluating disease progression and prognosis of neonatal hyperbilirubinemia.
【关键字】:高胆红素血症, 新生儿; 血流动力学
【Key words】:hyperbilirubinemia, neonatal; hemodynamics
【引证本文】:刘书艳. 脑血流动力学改变与新生儿高胆红素血症的相关性分析[J]. 临床肝胆病杂志, 2017, 33(10): 1974-1976.

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