Low cerebral blood flow velocity and head circumference in infants with severe hypoxic ischemic encephalopathy and poor outcome
Low cerebral blood flow velocity and head circumference in infants with severe hypoxic ischemic encephalopathy and poor outcome
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DOI：
10.1111/j.1651-2227.2008.01119.x
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发表时间：
2009-03-01
期刊：
影响因子：
3.8
通讯作者：
Metsvaht, Tuuli
中科院分区：
文献类型：
--
作者：
Ilves, Pilvi;Lintrop, Mare;Metsvaht, Tuuli
目的：为探讨窒息儿脑血流速度（CBFV）和头围的远期变化，对83例窒息儿和115例正常足月儿的大脑前、中动脉、基底动脉和颈内动脉（伊卡）的CBFV进行了测定，年龄为60-149天。随访18个月，观察智力发育和头围变化。平均CBFV增加（p < 0.05）在窒息后的第一天，重度缺氧缺血性脑病（HIE）婴儿（n = 25）与对照组或轻度至中度HIE婴儿（n = 58）相比，在36-71.9小时发现最大值：重度HIE婴儿伊卡（平均值[95% CI]）为31.2（25.5-36.6）cm/s，对照组为13.0（12.2-13.9）cm/s。重度HIE婴儿在21-59日龄时平均CBFV降低（p < 0.0001）：ICA组为14.1（11.5-16.8）cm/s，对照组为22.9（21.4-24.4）cm/s。结论：重度HIE新生儿窒息后第1天平均CBFV升高是暂时的，新生儿窒息后第2 1 ~ 5 9天CBFV和头围均降低。
Aims: To evaluate long-term changes in cerebral blood flow velocity (CBFV) and head circumference in asphyxiated infants.Methods: CBFV was measured in 83 asphyxiated and 115 healthy term infants in anterior and middle cerebral, basilar and internal carotid artery (ICA) up to the age of 60-149 days. The psychomotor development and head circumference was followed for 18 months.Results. Mean CBFV was increased (p < 0.05) during the first days after asphyxia in infants with severe hypoxic-ischemic encephalopathy (HIE) (n = 25) compared to control group or infants with mild to moderate HIE (n = 58) with maximum values found at the age of 36-71.9 h: in ICA (mean [95% CI]) 31.2 (25.5-36.6) cm/s in severe HIE infants compared to 13.0 (12.2-13.9) cm/s in controls. Decreased (p < 0.0001) mean CBFV developed in severe HIE infants by the age of 21-59 days: in ICA 14.1 (11.5-16.8) cm/s compared to 22.9 (21.4-24.4) cm/s in controls. Infants with severe HIE had similar mean height but lower head circumferences compared to controls (p < 0.05) at the age of 21-59 days.Conclusion: The high mean CBFV found in infants with severe HIE during the first days after asphyxia is temporary and low CBFV and head circumference develops by the age of 21-59 days.