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題名 | Pulsatile flow changes in the anterior cerebral arteries in infants with patent ductus arteriosus--Measured with doppler echocardiography=存開性動脈導管嬰兒前腦動脈之搏動性血流變化: 以杜卜勒超音波測量 |
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作者 | 吳建明; 洪焜隆; | 書刊名 | 中華民國小兒科醫學會雜誌 |
卷期 | 30:1 民78.01-02 |
頁次 | 頁7-14 |
分類號 | 417.517 |
關鍵詞 | 存開性動脈導管; 嬰兒前腦動脈; 搏動性血流變化; 杜卜勒超音波測量; |
語文 | 英文(English) |
中文摘要 | 在過去已經知道存開性動脈導管會減少全身性有效血流量以致容易造成許多器官的缺血現象。但由於是十分重要的人體器官,故常受到血流自動調整(autoregulation)的保護。本研究希望藉著杜卜勒超音波(ultrdsonic Doppler)測量前腦動脈的指敷(pulsatility index,簡稱PI)來評估具有存開性動脈導管的嬰兒其腦血管循環是否會受到影響?我們首先選擇在本院出生的32位正常新生兒,放彩色超音波確定動脈導管關閉前俊,各測其前腦動脈之PI值,並比較其變化。另外,我們有六例因心衰竭而住院的存開性動脈導管病嬰,其彩色超音波顯示沒有其他的先天性心臓異常,但下行主動脈在舒張期均有逆向回流;我們也利用相同的方法偵測其前腦動脈之PI值,並輿正常新生兒做比較。結果:在正常新生兒動脈導管關閉之前後的前腦動脈PI值分別爲0.65±0.07(range0.47-0.81)和0.63±0.05(range0.51-0.75),在統計學上,兩者是沒有明顯差異(P>0.1)。而6位病嬰前腦動脈PI值爲0.89±0.05(range0.85-0.99),輿前兩數值比較,在統計學上均有顯著差異(P值均小於0.005),此結果顯示動脈導管的存在並非一定會造成腦循環的障礙,但如果發生大的左至右分流現象則確實會影響到腦部血流。杜卜勒超普波是一種簡單、實用且無傷害性的檢查,我們建議所有存開性動脈導管的病人在接受手術結紮之前可以利用此技術先評估腦循環狀熊,並針對不正常者做較長期的神經學追蹤。 |
英文摘要 | Cerebral hemodynamics were measured, using the Doppler ultrasound technique (directed toward anterior cerebral artery through the anterior fontanel), in 6 patent ductus arteriosus (PDA) patients with large left to right shunt and in 32 neonates before and just following functional closure of ductus ateriosus. PDA was confirmed by color echocardiogram and Doppler flow study. All 6 sick babies had prominant retrograde flow in the descending aorta during diastole. The value of pulsatility index (PI) derived from the components of peak systolic and end-diastolic frequency, was calculated. An obvious higher PI with simultaneous decrease in diastolic Doppler frequency in sick babies(PI=0.89±0.05) were detected. On the contrary, the PI valves in the presence of opening of the ductus(PI=0.65±0.07) in normal newborn infants didn't differ significantly with those just following functional closure(PI=0.63±0.05). These data suggested that PDA might result in the physiologic consequence of ischemic cerebral injury if large left to right shunt occurred. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。