Autonomic Nervous System in Preterm Very Low Birth Weight Neonates with Intraventricular Hemorrhage
Autonomic Nervous System in Preterm Very Low Birth Weight Neonates with Intraventricular Hemorrhage
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早产极低出生体重新生儿脑室内出血的自主神经系统
DOI：
10.1055/a-1926-0335
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发表时间：
2022
影响因子：
2
通讯作者：
Hirayama Masahiro
中科院分区：
文献类型：
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作者：
Shiono Ai;Bonno Motoki;Toyoda Hidemi;Ogawa Masahiro;Tanaka Shigeki;Hirayama Masahiro
心率变异性（HRV）是心脏自主神经活动的指标，在新生儿期受到脑损伤的影响。我们的目的是确定是否存在相关性之间的HRV极早产儿和神经发育testscores.Study设计心电图数据的新生儿进行了评估和HRV模式在极早产儿严重脑室内出血（IVH;n= 6）和那些没有/轻度IVH（n= 28）进行了比较。我们分析了极早产儿18个月（n= 21）和3年（n= 23）HRV与神经发育结局的关系。结果极早产儿HRV与IVH严重程度显著相关（p< 0.05）。与无/轻度IVH的新生儿相比，重度IVH的新生儿表现出HR增加和平均R-R间期（NN）缩短。重度IVH组的HRV参数显著降低，但在无/轻度IVH组中没有，表明重度IVH新生儿的交感神经和副交感神经活动均降低。此外，在校正年龄分别为18个月和3岁时，无/轻度IVH组HR降低和NN增加与受损的神经发育结局显著相关（均P < 0.05）。HRV可以区分极早产儿谁随后有严重的IVH从那些谁没有/低度IVH。HRV可以识别需要辅助神经保护干预的极早产儿。这些发现值得在更大的极早产儿人群中进行进一步研究。关键点
ObjectiveHeart rate variability (HRV) indicates cardiac autonomic nerve activity and is influenced by brain damage during the neonatal period. We aimed to determine whether a correlation exists between the HRV of extremely preterm neonates and neurodevelopmental test scores.Study DesignElectrocardiogram data of neonates were assessed and HRV patterns in extremely preterm neonates with severe intraventricular hemorrhage (IVH;n= 6) and those with no/mild IVH (n= 28) were compared. We analyzed the relationship between HRV and neurodevelopmental outcomes at 18 months (n= 21) and 3 years (n= 23) in extremely preterm neonates.ResultsHRV was significantly associated with IVH severity in extremely preterm neonates (p< 0.05). Neonates with severe IVH exhibited increased HR and decreased mean R-to-R interval (NN) compared with neonates with no/mild IVH. HRV parameters significantly decreased in the severe IVH group, but not in the no/mild IVH group, suggesting that both sympathetic and parasympathetic activities decreased in neonates with severe IVH. Additionally, decreased HR and increased NN were significantly related to impaired neurodevelopmental outcomes in the no/mild IVH group at corrected ages of 18 months and 3 years, respectively (allp< 0.05).ConclusionHRV was significantly associated with IVH severity and neurodevelopmental outcome in extremely preterm neonates. HRV can distinguish extremely preterm neonates who subsequently had severe IVH from those who had no/low-grade IVH. HRV may identify extremely preterm neonates needing adjuvant neuroprotective interventions. These findings warrant further investigation in a larger population of extremely preterm neonates.Key Points