摘要
目的探讨无肺部病变的足月儿及不同胎龄早产儿肺功能的动态变化。方法回顾分析2010年7月至2012年8月在深圳市儿童医院新生儿科住院新生儿110例,按出生胎龄分为3组:足月JL(出生胎龄37-40周)组55例,其中男29例、女26例,平均出生体重(3.1±0.3)kg;晚期早产儿(出生胎龄34~〈37周)组30例,其中男18例、女12例,平均出生体重(2.1±0.3)kg;早期早产儿(出生胎龄〈34周)组25例,其中男16例、女9例,平均出生体重(1.4±0.3)蚝。在生后1、14及28日龄,进行潮气呼吸检测,运用反复呼吸气体洗出法技术,进行功能残气量(FRC)及肺清除指数(LCI)测量。各指标采用单因素方差分析方法统计。结果3组新生儿75%、50%、25%潮气量时呼气流速(TEF75、TEF50、TEF25)在第1、14及28天均逐渐升高,而呼吸频率则逐渐下降。足月儿组和晚期早产儿组在第28天TEF75、TEF50、TEF25、达峰时间比(T门EF/TE)、达峰容积比(VPEF/VE)值均明显高于早期早产儿组[(71±21)、(66±16)比(55±19)ml/s,(70±20)、(62±17)比(51±16)ml/s,(54±17)、(51±13)比(38±10)ml/s,37%±8%、34%±9%比29%±6%,38%±6%、33%±8%比28%±7%,F=5.82、8.74、11.30、7.72、16.40,均P〈0.01],而呼吸频率、LCI值则低[(49±6)、(51±8)比(56±7)次/min,8.6±2.7、8.9±2.2比10.8±2.0,F=10.09、7.15,均P〈0.05l。纠正胎龄40周时,足月儿组与晚期早产儿组TEF50、TEF25、TPTEF/TE、VPEF/VE仍均于早期早产儿组[(65±21)、(62±12)比(50±17)ml/s,(51±13)、(47±10)比(39±10)ml/s,36%±8%、31%±7%比30%±6%,37%±10%、32%±8%比29%±6%,F=4.41、8.23、9.08、7.35,均P〈0.05]。结论新生儿肺功能参数随日龄逐渐改善,早期早产儿组各项肺功�
Objective To explore the dynamic changes of lung function in infants born at different gestational ages without respiratory complications. Methods A total of 110 cases of hospitalized neonatal patients were retrospectively recruited and analyzed at Shenzhen Children's Hospital from July 2010 to August 2012. By gestational age they were divided into 3 groups of full term (37 - 40 weeks, n = 55, 29 males and 26 females) with an average birth weight (3.1 ± 0. 3) kg, late preterm group(34 - 〈37 weeks, n = 30, 18 males and 12 females)with an average birth weight (2. 1 ± 0. 3) kg and early preterm ( 〈 34 weeks, n = 25, 16 males and 9 females ) with an average birth weight ( 1.4 ± 0. 3 ) kg. At Days 1,14 and 28, lung function parameters of functional residual capacity ( FRC ) and lung clear index ( LCI ) were measured by multiple breath washouts with an ultrasonic flow meter and tidal breathing. One-way ANOVA was used for each index. Results Tidal expiratory flow 75% remaining tidal volume (TEF75). tidalexpiratory flow 50% remaining tidal volume (TEF50) and tidal expiratory flow 25% remaining tidal volume (TEF25) gradually increased at Days 1, 14 and 28 in 3 groups. However respiratory rate (RR) gradually decreased. Compared with full term and late preterm, the early preterm infants had lower TEF75, TEFS0 and TEF25, lower the ratios of time to peak expiratory flow and expiratory time ( TPTEF/TE), lower ratios of volume to peak expiratory flow and expiratory volume (VPEF/VE) ( (71 ±21 ) and (66 ± 16) vs (55 ± 19)ml/s,(70 ± 20) and (62 ± 17) vs (51 ± 16)ml/s, (54 ± 17) and (51 ± 13) vs (38 ± 10) ml/s, 37%±8% and 34% ±9% vs29%±6%,38%±6% and 33%±8% vs28%±7%,F=5.82, 8. 74, 11.30,7.72, 16.40, all P 〈0.01), higher RR and LCI at Day 28((49±6) and (51 ± 8) vs (56+7)/min, 8.6±2.7 and8.9±2.2vs 10.8±2.0,F=10.09, 7.15, bothP〈0.05). At amatched post-menstrual age of 40 weeks, eompared with
出处
《中华医学杂志》
CAS
CSCD
北大核心
2013年第24期1886-1890,共5页
National Medical Journal of China
基金
深圳市医疗重点学科专项建设基金(2001819)
关键词
呼吸功能试验
婴儿
新生
肺发育
Respiratory function tests
Infant, newborn
Lung development