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目的 评价早产儿心脏自主神经功能发育情况。方法 根据胎龄将 90例早产儿分为A、B、C三组 (胎龄分别为 2 7～ 31周、～ 34周、～ 37周 ) ,以CompasXMHolter系统检测 90例早产儿及 2 1例足月儿的心率变异性时域指标。结果 A、B、C三组 2 4h窦性RR间期标准差的均值 (SDNN)、每 5min窦性RR间期标准差的均值 (SDNNIDX)、5 0ms间隔以上邻近周期的比例 (PNN5 0 )与对照组比较差异有显著性意义 (P <0 0 5 )。A组SDNNIDX与B、C组比较 ,差异有显著性意义 (P <0 0 5 )。SDNN与胎龄正相关 (r =0 5 5 ,P <0 0 1) ,PNN5 0与日龄正相关 (r =0 2 3,P<0 0 5 )。结论 早产儿自主神经功能随胎龄增大逐渐成熟。胎龄大于 34周早产儿交感神经功能接近足月儿。大于 34周龄早产儿交感神经功能较稳定 ,副交感神经功能随日龄增加而增强。
Objective To evaluate the functional development of cardiac autonomic nerve in preterm infants. Methods Ninety preterm infants were divided into A, B and C groups according to gestational age (gestational age ranged from 27 to 31 weeks, to 34 weeks to 37 weeks). Ninety preterm infants and 21 infants were detected by CompasXMHolter system. Time-domain index of heart rate variability in term infants. Results SDNN of sinus RR interval, mean standard deviation of sinus RR interval every 5 minutes (SDNNIDX), ratio of adjacent cycles above 5 ms interval (PNN 50) Compared with the control group, the difference was significant (P <0 05). The difference between group A and group SDNNIDX was statistically significant (P <0.05). SDNN was positively correlated with gestational age (r = 055, P <0.01). PNN5 0 was positively correlated with age (r = 0 23, P <0 05). Conclusion The function of autonomic nerve in premature infants gradually matures with the increase of gestational age. Sympathetic nerve function in preterm infants with gestational age greater than 34 weeks is approaching full-term infants. Sympathetic function in preterm infants older than 34 weeks is more stable and parasympathetic function is enhanced with increasing age.