广西医学
廣西醫學
엄서의학
GUANGXI MEDICAL JOURNAL
2014年
7期
879-881
,共3页
万继荣%陈耀辉%方志松%李洁芳%陈淑芬%卢静儿%杨基龙%何敏华%梁宇珊%谢绛凝
萬繼榮%陳耀輝%方誌鬆%李潔芳%陳淑芬%盧靜兒%楊基龍%何敏華%樑宇珊%謝絳凝
만계영%진요휘%방지송%리길방%진숙분%로정인%양기룡%하민화%량우산%사강응
胎儿%宫内窘迫%新生儿窒息%心率变异性
胎兒%宮內窘迫%新生兒窒息%心率變異性
태인%궁내군박%신생인질식%심솔변이성
Fetus%Intrauterine distress%Neonatal asphyxia%Heart rate variability
目的：探讨宫内窘迫胎儿出生后心率变异性（ HRV）的变化特点及其临床意义。方法有宫内窘迫史的106例新生儿，根据Apgar评分分为无窒息组30例、轻度窒息组46例、重度窒息组30例，另选无宫内窘迫史的正常足月新生儿30例作对照组，于生后24 h内行动态心电图检查并分析心率变异性。结果无窒息组、轻度窒息组和对照组平均心率、最慢心率、最快心率比较，差异无统计学意义（P＞0．05），重度窒息组3项指标均低于无窒息组、轻度窒息组及对照组（P＜0．05）。无窒息组全部窦性心率R-R间期标准差、R-R间期均值的标准差、R-R间期标准的均值、相邻R-R间期差值的均方根、相邻R-R间期差值＞50 ms心搏数的百分比与对照组相比，差异无统计学意义（ P ＞0．05）；无窒息组、轻度窒息组上述5项指标均高于重度窒息组（ P＜0．05）。结论宫内窘迫胎儿出生后无窒息表现的新生儿HRV指标在正常范围内，而窒息新生儿HRV指标存在不同程度降低，且窒息程度越重HRV指标越低。
目的：探討宮內窘迫胎兒齣生後心率變異性（ HRV）的變化特點及其臨床意義。方法有宮內窘迫史的106例新生兒，根據Apgar評分分為無窒息組30例、輕度窒息組46例、重度窒息組30例，另選無宮內窘迫史的正常足月新生兒30例作對照組，于生後24 h內行動態心電圖檢查併分析心率變異性。結果無窒息組、輕度窒息組和對照組平均心率、最慢心率、最快心率比較，差異無統計學意義（P＞0．05），重度窒息組3項指標均低于無窒息組、輕度窒息組及對照組（P＜0．05）。無窒息組全部竇性心率R-R間期標準差、R-R間期均值的標準差、R-R間期標準的均值、相鄰R-R間期差值的均方根、相鄰R-R間期差值＞50 ms心搏數的百分比與對照組相比，差異無統計學意義（ P ＞0．05）；無窒息組、輕度窒息組上述5項指標均高于重度窒息組（ P＜0．05）。結論宮內窘迫胎兒齣生後無窒息錶現的新生兒HRV指標在正常範圍內，而窒息新生兒HRV指標存在不同程度降低，且窒息程度越重HRV指標越低。
목적：탐토궁내군박태인출생후심솔변이성（ HRV）적변화특점급기림상의의。방법유궁내군박사적106례신생인，근거Apgar평분분위무질식조30례、경도질식조46례、중도질식조30례，령선무궁내군박사적정상족월신생인30례작대조조，우생후24 h내행동태심전도검사병분석심솔변이성。결과무질식조、경도질식조화대조조평균심솔、최만심솔、최쾌심솔비교，차이무통계학의의（P＞0．05），중도질식조3항지표균저우무질식조、경도질식조급대조조（P＜0．05）。무질식조전부두성심솔R-R간기표준차、R-R간기균치적표준차、R-R간기표준적균치、상린R-R간기차치적균방근、상린R-R간기차치＞50 ms심박수적백분비여대조조상비，차이무통계학의의（ P ＞0．05）；무질식조、경도질식조상술5항지표균고우중도질식조（ P＜0．05）。결론궁내군박태인출생후무질식표현적신생인HRV지표재정상범위내，이질식신생인HRV지표존재불동정도강저，차질식정도월중HRV지표월저。
Objective To investigate the change characteristics of heart rate variability ( HRV) of neonates with intrauterine distress after birth and its clinical significance .Methods One hundred and six cases who had a neonatal intrauterine distress history were divided into non-asphyxia group (30 cases),mild asphyxia group (46 cases),severe asphyxia group(30 cases),30 normal full-term neonates without asphyxia as control group .Dynamic electrocardiogram was conducted in the neonates within 24 hours after birth for the analysis of heart rate variability .Results There were no significant differences in average heart rate , the slowest heart rate and the fastest heart rate among non-asphyxia group,mild asphyxia group and severe asphyxia group (P>0.05),the 3 indexes in the severe asphyxia were lower than those in the non-asphyxia group ,mild asphyxia group and control group ( P<0.05) .There were no significant differences in 5 indexes(SDNN,SDANN,SDNN,rMSSD,pNN50) between non-asphyxia group and control group (P>0.05),and the 5 indexes above in the non-asphyxia group ,mild asphyxia group were higher than those in the severe asphyxia group (P<0.05).Conclusion The HRV of intrauterine distress neonate after birth without asphyxia is normal ,which of neonate with asphyxia decreases in different degrees .And more severe asphyxia ,lower HRV.
