Cardiovascular fluctuations and transfer function analysis in stable preterm infants
Cardiovascular fluctuations and transfer function analysis in stable preterm infants
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DOI：
10.1203/01.pdr.0000041514.73559.7d
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发表时间：
2003-01-01
影响因子：
3.6
通讯作者：
Blanco, CE
中科院分区：
文献类型：
--
作者：
Andriessen, P;Koolen, AMP;Blanco, CE
为了检测压力感受器反射功能，对10名胎龄合适且病情稳定的早产儿（胎龄范围为27.2 - 33.7周）在出生后第一周安静睡眠期间的收缩压（SBP）和R - R间期波动进行了逐搏分析。采用快速傅里叶变换进行频谱功率分析，并估算了低频段（LF，0.03 - 0.2 Hz）和高频段（HF，定义为个体呼吸频率的第10和第90百分位数之间的频段）中SBP和R - R波动之间的传递函数（增益和相位差）。LF/HF比值反映交感 - 迷走神经平衡。LF峰的平均频率（±标准差）集中在0.07 ± 0.02 Hz。个体HF频段的平均频率（±标准差）为0.82 ± 0.21 Hz。R - R间期序列中的LF/HF比值[中位数为29；四分位间距（IQR）为16 - 40]高于SBP序列（中位数为8；IQR为4 - 14）。LF频段中R - R间期和SBP波动之间的增益（中位数为4.2 ms/mmHg；IQR为2.4 - 5.0）高于HF频段（中位数为1.7 ms/mmHg；IQR为1.4 - 3.0）。在LF频段，SBP波动领先于R - R间期波动，中位相位差为 + 96°（IQR为67 - 132）。在LF频段，SBP的波动先于R - R间期的变化，时间延迟为3.8秒。这些观察结果表明，与已发表的成人数据相比，交感神经系统在稳定的早产儿中起主导作用。交叉频谱分析可用于检测新生儿交感神经系统的发育情况。
To examine the baroreceptor reflex function, a beat-to-beat analysis between systolic blood pressure (SBP) and R-R interval fluctuations was studied in 10 stable appropriate-for-gestational age preterm infants (range, 27.2-33.7 wk) in the first postnatal week during quiet sleep. Spectral power analysis, using fast Fourier transform, and transfer functions (gain and phase difference) between SBP and R-R fluctuations were estimated in a low-frequency band (LF, 0.03-0.2 Hz) and high-frequency band (HF defined as the frequency band between the 10th and 90th centiles of the individual respiratory frequency). The LF/HF ratio reflects the sympathovagal balance. The mean frequency (+/-SD) of LF peaks was centered at 0.07 +/- 0.02 Hz. The mean frequency (+/-SD) of the individual HF band was 0.82 +/- 0.21 Hz. The LF/HF ratio in the R-R interval series [median, 29; interquartile range (IQR), 16-40] was higher than in the SBP series (median, 8; IQR, 4-14). The gain between R-R interval and SBP fluctuations (median, 4.2 ms/mm Hg; IQR, 2.4-5.0) in the LF band was higher than in the HF band (median, 1.7 ms/mm Hg; IQR, 1.4-3.0). SBP fluctuations lead R-R interval fluctuations in the LF band with a median phase difference of +96degrees (IQR, 67-132). At LF the fluctuations in SBP precede changes in R-R interval with a time delay of 3.8 s. These observations indicate a dominant role of the sympathetic system in stable preterm infants in comparison with published adult values. Cross-spectral analysis allows a test for tracking the development of the sympathetic system in neonates.