新生儿静脉导管血流动力学与肝功能的相关性研究
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中山市中医院超声科

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2015年中山市科技计划项目《超声评估新生儿静脉导管闭合时间及Z值的分析研究》(项目编号:2015B1051)


Correlational study between hemodynamics of the ductus venosus and liver function in neonates
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    摘要:

    【】目的 探讨不同胎龄新生儿静脉导管血流动力学指标与肝功能的关系。方法 选择确诊为静脉导管未闭的新生儿175例作为病例组,并依据胎龄分为A组(55例,胎龄31~34周)、B组(58例,胎龄35~37周)、C组(62例,胎龄38~40周),于出生后2~3天应用彩色多普勒超声检测各组新生儿静脉导管内径、平均血流速度并计算血流量;选择确诊为静脉导管闭合的新生儿60例作为对照组(胎龄38~40周);观察各组肝功能指标[谷丙转氨酶(ALT)、谷草转氨酶(AST)、总胆汁酸(TBA)、血氨(NH3)、血清总蛋白(TP)]及凝血酶原时间(PT)的变化。结果 A组的静脉导管血流量明显大于B组及C组,B组的静脉导管血流量大于C组,三组间差异有统计学意义(P<0.01);A组的ALT、AST高于B组、C组及对照组(P<0.01),但B组、C组与对照组间比较差异无统计学意义(P>0.05);A组的TBA、NH3及PT均高于B组及C组,A组的TP低于B组及C组,三组间差异有统计学意义(P<0.01),但C组的TBA、NH3、TP、PT与对照组比较差异均无统计学意义(P>0.05)。结论 新生儿胎龄越小,未闭合的静脉导管血流量越大,其所引起的较大量门体静脉分流会对肝功能产生影响,而且静脉导管分流量越大,对新生儿肝功能影响越明显。

    Abstract:

    【】Objective To investigate the relation of hemodynamic parameters of the ductus venosus and liver function in neonates with different gestational age. Methods 175 newborns diagnosed with patent ductus venous were divided into Group A(55 cases, gestational age from 31 to 34 weeks), Group B(58 cases, gestational age from 35 to 37 weeks), Group C(62 cases, gestational age from 38 to 40 weeks) according to the gestational age. The ductus venosus diameter and blood flow velocity of the neonates were detected by color Doppler ultrasound, and the blood flow volume was also calculated. 60 newborns diagnosed with ductus venous closure were chosen as Control group. The changes of liver function indexes [including alanine aminotransferase (ALT) and aspartate transaminase (AST), total bile acid (TBA), blood ammonia (NH3) and serum total protein (TP)] and prothrombin time(PT) were all observed in all groups. Results Group A had significantly higher blood flow volume of ductus venous than Group B and Group C, Group B had higher blood flow volume than Group C, and the differences among the three groups were statistically significant(P<0.01). ALT and AST levels of Group A were higher than those of Group B and Group C, but the differences amoung Group B、Group C and Control group had no statistical significance(P>0.05). TBA、NH3 and PT levels of Group A were higher than those of Group B and Group C, and TP level of GroupA was lower than those of Group B and Group C, and the differences among the three groups were statistically significant(P<0.01), but the differences between Group C and Control group had no statistical significance(P>0.05). Conclusions The blood flow volume of ductus venous got higher with decreasing gestational age in neonates. Besides, the portal vein shunt caused by patent ductus venous in neonates had a certain impact on liver function, and the effect on neonatal liver function was more obvious with the higher blood flow volume of ductus venous.

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黄志勇.新生儿静脉导管血流动力学与肝功能的相关性研究[J].临床超声医学杂志,2017,19(11):

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  • 收稿日期:2016-11-14
  • 最后修改日期:2017-10-16
  • 录用日期:2017-01-04
  • 在线发布日期: 2017-12-11
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