早期动脉血气分析与早产儿脑损伤相关性研究

doi:10.11852/zgetbjzz2015-23-01-17

中国儿童保健杂志 ›› 2015, Vol. 23 ›› Issue (1): 55-57.DOI: 10.11852/zgetbjzz2015-23-01-17

早期动脉血气分析与早产儿脑损伤相关性研究

马江林,卢红艳,王秋霞

江苏大学附属医院儿科,江苏镇江 212013

收稿日期:2014-04-04 发布日期:2015-01-10 出版日期:2015-01-10
通讯作者: 卢红艳,E-mail:lhy5154@163.com
作者简介:马江林(1986-),男,山东人,医学硕士,主要研究方向为早产儿脑损伤
基金资助:
江苏省科技创新与成果转化(生命健康科技)专项资金(BL2012058)

Correlation between early arterial blood gas analysis and brain injury in preterm infants.

MA Jiang-lin,LU Hong-yan,WANG Qiu-xia

Department of Pediatrics,the Affilitated Hospital of Jiangsu University,Zhenjiang,Jiangsu,212001,China
Correlation author:LU Hong-yan,E-mail:lhy5154@163.com

Received:2014-04-04 Online:2015-01-10 Published:2015-01-10

摘要/Abstract

摘要： 目的分析生后早期动脉血气分析与早产儿脑损伤的相关性,为早产儿脑损伤的早期发现和干预提供参考依据。方法收集2010年1月-2012年12月本院有生后1 h内动脉血气分析结果的早产儿,抽取脑损伤早产儿51例,按1∶3比例抽取3份相同或相近孕周产科分娩的无脑损伤早产儿为对照组,对两组早产儿血气分析中PH值、PaO₂、PaCO₂、BE值与脑损伤关系进行比较,并进行相关性分析,探讨早期动脉血气分析与早产儿脑损伤的相关性,评估早期动脉血气分析在预测早产儿脑损伤中的价值。结果早产儿脑损伤检出率为16.4%,其中脑室内出血检出率为13.4%,脑室周围白质软化检出率为3.0%。脑损伤组PH(7.23±0.13)、PaO₂(68.53±30.85)、BE(-6.50±3.93)值较对照组PH(7.32±0.08)、PaO₂(81.05±29.19)、BE (-4.04±3.66)明显降低(P均<0.01)。PaCO₂(50.16±14.13)较对照组(44.30±10.27)明显升高(P<0.01)。进一步研究发现:当PH<7.15、PaO₂<35 mmHg、PaCO₂>65 mmHg、BE<-10 mmol/L时,早产儿脑损伤发生率明显增加。Logistic回归分析显示:PH<7.15、PaO₂<35 mmHg、PaCO₂>65 mmHg与早产儿脑损伤密切相关,OR值(95%CI)分别为0.14(0.03～0.68)、0.04(0.01～0.68)、0.06(0.01～0.55)。结论早期动脉血气分析异常与早产儿脑损伤密切相关,早产儿脑损伤发生率明显增加,提示早期监测动脉血气分析,及时纠正低氧血症、高碳酸血症、代谢性酸中毒,可减轻早产儿脑损伤发生发展。

关键词: 早产儿, 脑损伤, 动脉血气分析

Abstract: Objective To investigate the correlation between early arterial blood gas analysis and brain injury in preterm infants,and further to provide reference for early diagnosis and intervention of it. Methods The preterm infants with arterial blood gas analysis results in 1 hour after birth in our hospital from Jan.2010 to Dec.2011 were collected.51 infants diagnosed as brain injury were selected as case group,and each case were matched with 3 normal infants with same gestational age as control group.PH,PaO₂,PaCO₂,BE between the two groups were compared,and the correlation analysis on their relationship with brain injury were carried out. Results The incidence of brain injury in preterm infants was 16.4%,IVH and PVL were 13.4% and 3.0% respectively.PH(7.23±0.13),PaO₂(68.53±30.85),BE(-6.50±3.93)from the brain injury group were significantly lower than those from the control group (7.32±0.08,81.05±29.19,-4.04±3.66)(all P＜0.01),while PaCO₂(50.16±14.13) was significantly higher than that of the control group(44.30±10.27)(P＜0.01).Further research,when PH<7.15,PaO₂<35 mmHg,PaCO₂>65 mmHg,BE<-10 mmol/L,the incidence of brain injury in preterm infants increased.And logistic analysis showed that PH<7.15,PaO₂<35 mmHg,PaCO₂>65 mmHg were closely related to brain injury in preterm infants,values of OR (95%CI) were 0.14(0.03～0.68),0.04(0.01～0.68),0.06(0.01～0.55) respectively. Conclusions Early arterial blood gas analysis are closely related to brain injury in preterm infants.

Key words: preterm infants, brain injury, early arterial blood gas

中图分类号:

R722.6

马江林,卢红艳,王秋霞. 早期动脉血气分析与早产儿脑损伤相关性研究[J]. 中国儿童保健杂志, 2015, 23(1): 55-57.

MA Jiang-lin,LU Hong-yan,WANG Qiu-xia. Correlation between early arterial blood gas analysis and brain injury in preterm infants.[J]. journal1, 2015, 23(1): 55-57.

参考文献

[1] Vengust M.Hypercapnic respiratory acidosis:a protective or harmful strategy for critically ill newborn foals?[J].Can J Vet Res,2012,76(4):275-280.
[2] 中华医学会儿科学分会新生儿学组.早产儿脑室周围一脑室内出血与脑室周围白质软化的诊断建议[J].中华儿科杂志,2007,45(1):34-36.
[3] 田鸾英.早产儿脑损伤的患病率和危险因素[J].实用儿科临床杂志,2011,26(2):128-130.
[4] 陈惠金,魏克伦,周丛乐,等.中国七大城市早产儿脑损伤发生率的多中心调查报告[J].临床儿科杂志,2011,29(11):1001-1011.
[5] Pahlavan PS,Sutton W,Buist RJ,et al.Multifocal haemorrhagic brain damage following hypoxia and blood pressure lability:case report and rat model[J].Neuropathol Appl Neurobiol,2012,38(7):723-733.
[6] Chalak LF,Rollins N,Morriss MC,et al.Perinatal acidosis and hypoxic-ischemic encephalopathy in preterm infants of 33 to 35 weeks' gestation[J].J Pediatr,2012,160(3):388-394.
[7] 王钰,尹晓娟,李丽,等.窒息新生儿并发脑损伤相关因素分析[J].中国儿童保健杂志,2013,21(7):746-749.
[8] Brehmer F,Bendix I,Prager S,et al.Interaction of inflammation and hyperoxia in a rat model of neonatal white matter damage[J].PLoS One,2012,7(11):e49023.
[9] Resch B,Neubauer K,Hofer N,et al.Episodes of hypocarbia and early-onset sepsis are risk factors for cystic periventricular leukomalacia in the preterm infant[J].Early Hum Dev,2012,88(1):27-31.
[10] Zhou Q,Cao B,Niu L,et al.Effects of permissive hypercapnia on transient global cerebral ischemia-reperfusion injury in rats[J].Anesthesiology,2010,112(2):288-297.
[11] Tao T,Liu Y,Zhang J,et al.Therapeutic hypercapnia improves functional recovery and attenuates injury via antiapoptotic mechanisms in a rat focal cerebral ischemia/reperfusion model[J].Brain Res,2013,1533:52-62.
[12] Brew N,Walker D,Wong FY.Cerebral vascular regulation and brain injury in preterm infants[EB/OL].Am J Physiol Regul Integr Comp Physiol,2014.http//pubmed.cn/24647591.

[1]	张丹, 张军, 杨钰荣, 曹咪, 闫敬敏, 朱璐阳. 肠道菌群与早产儿脑发育及神经认知行为关系的研究[J]. 中国儿童保健杂志, 2023, 31(7): 756-759.
[2]	冯骁, 陈凌, 赵红缨, 黄蕊, 林辰曦, 庄丽娟. 不同脐带挤压方式对极早产儿结局的影响[J]. 中国儿童保健杂志, 2023, 31(7): 794-798.
[3]	郑亭玉, 张春宇, 杨飞, 郑芳, 张梦霞, 夏露萍, 徐孙超. 营养支持小组管理模式对早产儿生长发育及免疫功能的影响[J]. 中国儿童保健杂志, 2023, 31(5): 555-558.
[4]	夏正龙, 宋燕燕. 支气管肺发育不良早产儿神经发育研究[J]. 中国儿童保健杂志, 2023, 31(4): 390-394.
[5]	李静兰, 孙文强, 朱雪萍. 早产儿支气管肺发育不良相关预测模型研究[J]. 中国儿童保健杂志, 2023, 31(4): 395-398.
[6]	王娜, 李晓莺. 早产儿神经发育评估的进展[J]. 中国儿童保健杂志, 2023, 31(4): 404-407.
[7]	任力, 黑明燕, 齐宇洁, 靳绯, 翁景文, 董世霄, 沈艳华, 姜敏. 早产儿喂养对坏死性小肠结肠炎发病的影响[J]. 中国儿童保健杂志, 2023, 31(4): 438-441.
[8]	陈峰, 张宇. 多胞胎和单胞胎早产儿神经发育的回顾性研究[J]. 中国儿童保健杂志, 2023, 31(4): 451-456.
[9]	王晶, 项思嘉, 鲁莹, 杨蕾, 胡小沙, 钱君, 池霞, 张敏. 早产儿3周岁体格生长及体成分分析[J]. 中国儿童保健杂志, 2023, 31(4): 457-460.
[10]	郑水英, 罗艳赟. 早产儿喂养不耐受的临床表现及相关影响因素[J]. 中国儿童保健杂志, 2023, 31(4): 461-464.
[11]	张雨平. 婴幼儿脑损伤及其早期评估[J]. 中国儿童保健杂志, 2023, 31(2): 123-125.
[12]	曹冰冰, 林多华, 杜佩珍, 颜陶, 程建婷. 多种实验室指标和炎性因子表达水平与新生儿神经发育的相关性研究[J]. 中国儿童保健杂志, 2023, 31(2): 205-209.
[13]	何小颖, 吴翠玲, 曾玲艳, 綦美姣, 孙亚莲. 早产儿食物转换对血清营养素水平的影响[J]. 中国儿童保健杂志, 2023, 31(1): 81-85.
[14]	王慧冉, 罗荣, 胡文玲. 2019年3所妇幼保健院早产儿视网膜病变筛查及随访分析[J]. 中国儿童保健杂志, 2023, 31(1): 105-108.
[15]	和娇吉, 刘孝美, 唐孟言, 罗红, 杨速飞, 彭文涛. 基于AIMS分析早产儿运动发育现状及影响因素[J]. 中国儿童保健杂志, 2022, 30(7): 779-782.

早期动脉血气分析与早产儿脑损伤相关性研究

Correlation between early arterial blood gas analysis and brain injury in preterm infants.

PDF

可视化

被引次数

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 15

编辑推荐

Metrics