Hemodynamics of the cerebral arteries of infants with periventricular leukomalacia
Hemodynamics of the cerebral arteries of infants with periventricular leukomalacia
复制标题
DOI：
10.1542/peds.2004-1719
复制
发表时间：
2006-01-01
期刊：
影响因子：
8
通讯作者：
Togari, H
中科院分区：
文献类型：
--
作者：
Fukuda, S;Kato, T;Togari, H
OBJECTIVE.本研究旨在探讨脑室周围白质软化症（PVL）患儿脑动脉血流的发育变化，以明确PVL的发病时间。67例低出生体重儿中8例经超声诊断为PVL伴囊肿形成。应用多普勒超声检测出生后0、1、2、3、4、5、7、10、14、21、28、42、56和70天大脑前动脉、大脑中动脉（MCA）、大脑后动脉（PCA）、颈内动脉（ICA）和基底动脉的平均脑血流速度（CBFV）。8例囊肿形成的婴儿中有4例发生脑瘫，59例无囊肿形成的婴儿中有1例发生脑瘫。PVL患儿大脑前动脉平均CBFV明显降低（第14 - 70天），右侧MCA（第14 - 70天），左侧MCA（第14 - 70天），右PCA（第7 - 70天）、左侧PCA（第5 - 70天）、右侧伊卡（第7 - 70天）、左侧伊卡（第7 - 70天）和基底动脉（第14和28 - 70天）。在第0天，PVL婴儿的所有动脉中的CBFV也低于完整婴儿。脑完整的婴儿PCA的CBFV在出生后增加，而PVL婴儿在14天或21天后保持不变。两组脑瘫的患病率有显著差异。我们认为，囊性PVL的情况下，总的脑血供减少，这种减少发生在出生后，在一个确定的顺序，在脑动脉。我们的结论是，导致PVL的侮辱可能发生在接近出生的时间。
OBJECTIVE. This study investigated the developmental changes in blood flow in each cerebral artery among infants with and without periventricular leukomalacia (PVL), to elucidate the time of onset of PVL.METHODS. Eight of 67 low birth weight infants were diagnosed through ultrasonography as having PVL with cyst formation. The mean cerebral blood flow velocities (CBFVs) in the anterior cerebral artery, middle cerebral arteries (MCAs), posterior cerebral arteries (PCAs), internal carotid arteries (ICAs), and basilar artery were measured with Doppler ultrasonography at postnatal days 0, 1, 2, 3, 4, 5, 7, 10, 14, 21, 28, 42, 56, and 70. Four of 8 infants with cyst formation and 1 of 59 infants without cyst formation developed cerebral palsy.RESULTS. The mean CBFVs of infants with PVL were significantly lower in the anterior cerebral artery (days 14 - 70), the right MCA (days 14 - 70), the left MCA (days 14 - 70), the right PCA (days 7 - 70), the left PCA (days 5 - 70), the right ICA ( days 7 - 70), the left ICA (days 7 - 70), and the basilar artery (days 14 and 28 - 70). The CBFVs in all arteries were also lower among those with PVL than among intact infants on day 0. The CBFVs increased postnatally in the PCAs of infants with intact brains, whereas they remained unchanged after day 14 or 21 among infants with PVL. There was a significant difference in the prevalence of cerebral palsy between the 2 groups.CONCLUSIONS. We suggest that the total cerebral blood supply is decreased in cases of cystic PVL and that this reduction occurs just after birth, in a defined sequence, in the cerebral arteries. We conclude that the insult resulting in PVL might occur close to the time of birth.