中国儿童保健杂志 ›› 2021, Vol. 29 ›› Issue (12): 1343-1346.DOI: 10.11852/zgetbjzz2020-1898

• 临床研究 • 上一篇    下一篇

灌注指数监测新生儿血流动力学的有效性研究

刘雪琴1, 贺玉娟1, 张卫星1, 沈洁1, 刘玉霞1, 赵宝君1, 唐成和2   

  1. 1.新乡市中心医院,新乡医学院第四临床学院河南 新乡 453000;
    2.新乡医学院第一附属医院
  • 收稿日期:2020-10-29 修回日期:2020-12-25 发布日期:2021-12-09
  • 通讯作者: 唐成和,E-mail:tch8275@163.com
  • 作者简介::刘雪琴(1978-),女,河南人,副主任医师,硕士学位,主要研究方向为新生儿疾病。
  • 基金资助:
    2019年度河南省医学科技攻关计划联合共建项目(LHGJ20191319);2018 年度河南省医学科技攻关计划联合共建项目(2018020926)

Study on the effectiveness of perfusion index in neonatal hemodynamic monitoring

LIU Xue-qin*, HE Yu-juan, ZHANG Wei-xing, SHEN Jie, LIU Yu-xia, ZHAO Bao-jun, TANG Cheng-he   

  1. *Xinxiang Central Hospital,the Fourth Clinical College Xinxiang Medical University,Xinxiang,Henan 453000,China
  • Received:2020-10-29 Revised:2020-12-25 Published:2021-12-09
  • Contact: TANG Cheng-he,E-mail:tch8275@163.com

摘要: 目的 分析灌注指数(PI)监测新生儿循环的有效性,为新生儿循环监测寻找一种敏感、简便的方法。 方法 选择2018年10月—2019年7月入住新乡市中心医院新生儿重症监护室(NICU)的新生儿,入院后进行新生儿危重病评分(NCIS),评分>90分为非危重,70~90分为危重,<70分为极危重。选择病情危重和极危重时进行有创动脉血压监测的患儿54例,记录平均动脉压(MAP),并同时监测PI、动脉血乳酸值、心率、SPO2和左室射血分数(EF)。 结果 1)PI与MAP之间呈中度正相关(r=0.724,P<0.01),与血乳酸之间呈中度负相关(r=-0.688,P<0.01),与心率、SPO2、左室射血分数(EF)之间无相关性;2)PI与MAP之间ROC曲线分析示:截断点0.67,敏感性87.8%,特异性76.9%,AUC 0.872(P<0.01);3)PI与血乳酸之间ROC曲线分析示:截断点1.35,敏感性100.0%,特异性77.3%,AUC 0.931,P<0.01。 结论 PI是监测新生儿循环的敏感指标。

关键词: 灌注指数, 平均动脉压, 动脉血乳酸, 新生儿危重病例评分

Abstract: Objective To explore the effectiveness of perfusion index (PI) in monitoring neonatal circulation,so as to find out a sensitive and easy way for circulation monitoring of neonates. Methods Newborns admitted to the Neonatal Intensive Care Unit (NICU) of Xinxiang Central Hospital from October 2018 to July 2019 were selected,and the neonatal critical illness score (NCIS) was performed after admission. The score >90 was non-critical,the score between 70 and 90 was critical,and the score<70 was extremely critical. Fifty-four children who were in critical or extremely critical condition and underwent invasive blood pressure monitoring with the consent and signature of their families were selected and included in the study. Mean arterial pressure (MAP) was recorded,and PI,blood lactic acid,heart rate,SPO2 and left ventricular ejection fraction (EF) were monitored simultaneously. Results 1)There was a moderate positive correlation between PI and MAP (r=0.724,P=0.01) and a moderate negative correlation between PI and blood lactic acid (r=-0.688,P<0.01). The correlation between PI and heart rate,SPO2,left ventricular ejection fraction (EF) was not significant. ROC curve showed that when the cut-off point of PI was 0.67,the sensitivity and specificity of PI for predicting MAP were 87.8% and 76.9%,with the AUC of 0.872 (P<0.01). When the cut-off point of PI was 1.35,the sensitivity and specificity of PI for predicting blood lactic acid were 100.0% and 77.3%,with the AUC of 0.931(P<0.01). Conclusions PI is a sensitive index for monitoring neonatal circulation.

Key words: perfusion index, mean arterial pressure, arterial blood lactic acid, neonatal critical illness score

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