中国小儿急救医学
中國小兒急救醫學
중국소인급구의학
CHINESE PEDIATRIC EMERGENCY MEDICINE
2012年
1期
59-61
,共3页
李敏%谢利剑%刘万红%顾月萍%王健怡%陈一欢%裘刚
李敏%謝利劍%劉萬紅%顧月萍%王健怡%陳一歡%裘剛
리민%사리검%류만홍%고월평%왕건이%진일환%구강
新生儿窒息%心率变异性%自主神经%婴儿,新生
新生兒窒息%心率變異性%自主神經%嬰兒,新生
신생인질식%심솔변이성%자주신경%영인,신생
Neonatal asphyxia%Heart rate variability%Autonomic nervous%Infant,newborn
目的 探讨窒息新生儿心率变异性(heart rate variability,HRV)与心肌损害的相关性.方法 对53例窒息新生儿与40例健康新生儿进行24h全程动态心电图记录,对24h窦性心律进行HRV时域分析,时域分析指标包括:正常窦性R-R间期的标准差(SDNN);全程记录中每5分钟R-R间期平均值的标准差(SDANN);全程记录中每5分钟R-R间期标准差的平均值(SDNNindex);相邻R-R间期差值的均方根值(rMSSD);正常R-R间期标准差>50 ms的百分比(PNN50).结果 (1)窒息新生儿与正常对照新生儿24h最快心率、最慢心率、平均心率比较,差异均有统计学意义(P<0.05);轻、重度窒息新生儿间以上指标比较差异也有统计学意义(P<0.05);重度窒息3种心率指标明显降低.(2) HRV时域分析中,轻、重度窒息新生儿SDNN、SDANN与正常对照新生儿比较差异有统计学意义(P<0.05),轻、重度窒息SDNN、SDANN、SDNNindex、rMSSD及PNN50 5项指标组间比较差异无统计学意义(P>0.05).SDNNindex、rMSSD及PNN503组间未见明显差异.结论 新生儿窒息心肌损害会导致心脏自主神经功能受损并影响心率的变化,受损程度与窒息缺氧严重程度有关.
目的 探討窒息新生兒心率變異性(heart rate variability,HRV)與心肌損害的相關性.方法 對53例窒息新生兒與40例健康新生兒進行24h全程動態心電圖記錄,對24h竇性心律進行HRV時域分析,時域分析指標包括:正常竇性R-R間期的標準差(SDNN);全程記錄中每5分鐘R-R間期平均值的標準差(SDANN);全程記錄中每5分鐘R-R間期標準差的平均值(SDNNindex);相鄰R-R間期差值的均方根值(rMSSD);正常R-R間期標準差>50 ms的百分比(PNN50).結果 (1)窒息新生兒與正常對照新生兒24h最快心率、最慢心率、平均心率比較,差異均有統計學意義(P<0.05);輕、重度窒息新生兒間以上指標比較差異也有統計學意義(P<0.05);重度窒息3種心率指標明顯降低.(2) HRV時域分析中,輕、重度窒息新生兒SDNN、SDANN與正常對照新生兒比較差異有統計學意義(P<0.05),輕、重度窒息SDNN、SDANN、SDNNindex、rMSSD及PNN50 5項指標組間比較差異無統計學意義(P>0.05).SDNNindex、rMSSD及PNN503組間未見明顯差異.結論 新生兒窒息心肌損害會導緻心髒自主神經功能受損併影響心率的變化,受損程度與窒息缺氧嚴重程度有關.
목적 탐토질식신생인심솔변이성(heart rate variability,HRV)여심기손해적상관성.방법 대53례질식신생인여40례건강신생인진행24h전정동태심전도기록,대24h두성심률진행HRV시역분석,시역분석지표포괄:정상두성R-R간기적표준차(SDNN);전정기록중매5분종R-R간기평균치적표준차(SDANN);전정기록중매5분종R-R간기표준차적평균치(SDNNindex);상린R-R간기차치적균방근치(rMSSD);정상R-R간기표준차>50 ms적백분비(PNN50).결과 (1)질식신생인여정상대조신생인24h최쾌심솔、최만심솔、평균심솔비교,차이균유통계학의의(P<0.05);경、중도질식신생인간이상지표비교차이야유통계학의의(P<0.05);중도질식3충심솔지표명현강저.(2) HRV시역분석중,경、중도질식신생인SDNN、SDANN여정상대조신생인비교차이유통계학의의(P<0.05),경、중도질식SDNN、SDANN、SDNNindex、rMSSD급PNN50 5항지표조간비교차이무통계학의의(P>0.05).SDNNindex、rMSSD급PNN503조간미견명현차이.결론 신생인질식심기손해회도치심장자주신경공능수손병영향심솔적변화,수손정도여질식결양엄중정도유관.
Objective To explore the relation of heart rate variability (HRV) in neonatal asphyxia with myocardial injury.Methods Continuous electrocardiographic monitoring by 24-hour Holter recordings was performed in 53 neonates with asphyxia and 40 healthy newborn.The difference of HRV with sinus rhythm was analyzed.Time-domain indexs included standard deviation of R-R intervals (SDNN) ; standard deviation of all mean 5-minute R-R intervals (SDANN) ;standard deviation of all R-R intervals for all 5-minute segments of 24 hours (SDNNindex ) ;root mean squared successive difference (rMSSD) ;percent of NN50 in the total number R-R intervals ( PNN50 ).Results ( 1 ) Maximum heart rate,minimum heart rate and average heart rate of 24-hour Holter in healthy newborn were faster than those in newborn with neonatal asphyxia ( P < 0.05 ).And the heart rate was faster in newborn with mild neonatal asphyxia than that in newborn with serious neonatal asphyxia ( P < 0.05 ).(2) SDNN,SDANN of HRV index analysis showed significantly difference between healthy newborn and asphyxia newhom ( P < 0.05 ).There were no difference of SDNN,SDANN,SDNNindex,rMSSD and PNN50 between mild and serious neonatal asphyxia (P > 0.05 ).No significant differences of SDNNindex,rMSSD and PNN50 were found among three groups.Conclusion Myocardial injury caused by neonatal asphyxia can lead to damage of cardiac autonomic nevous and affect heart rate changes.The degree of myocardial injury is related to the degree of neonatal asphyxia.