早产儿心脏储备功能的临床研究

摘要

目的:探讨不同孕周出生的新生儿心脏储备功能差异.方法:早产儿和足月儿461例,其中早产儿195例,足月儿266例纳入本研究.基于数字心音信号处理技术,采用运动心力监测仪,测量、计算和分析各孕周新生儿心率(HR)、第一心音幅值与第二心音幅值的比值(S1/S2)和舒张期时限与收缩期时限的比值(D/S)的变化趋势并分析.结果:①足月儿的D/S比值均分布于≥0.80,而早产儿的D/S分布在0.66～ 1.20,1％的早产儿D/S ＜0.80.②早产儿195例,足月儿266例心脏储备状态指标D/S与孕周有相关性,HR、S1/S2与孕周无明显相关性.③足月儿和早产儿的D/S之间差异有统计学意义(P＜0.05).结论:足月儿的心脏储备功能强于早产儿；基于心音图的新生儿心脏储备功能的无创检测方法值得临床推广应用.%Objective:To explore the differences of cardiac reserve function between full term and preterm infant. Methods;266 full term and one hundred and 195 preterm infants were enrolled in this study. Based on the digital technique of heart sound signal processing, the heart rate (HR), the ratio of the amplitude of the first heart sound to the second heart sound (S1/S2) and the ratio of diastolic to systolic duration (D/S) of full term and preterm infants were measured, calculated and analyzed by the Sport Cardiac Contractility Mo- . Nitor. Results: All the full term infants (37～41 +6 weeks group) were found D/S≥0.80. However the D/S of preterm infants (28～36+6weeks group) ranged from 0. 66 to 1. 20, in which 1 % preterm infants were found D/S <0.80. A correlation was found between D/S and gestational weeks, .whilst no significant correlationwas found between each other of HR, S1/S2 and gestational weeks. The D/S of full term infants was found significantly different when compared to preterm infants( P<0. 05). Conclusions;The cardiac reserve function of full term infant, is stronger than the preterm infant The non-invasive phonocardiogram for testing the cardiac reserve function of neonate has a promising future.