| 摘要: |
| ［摘要］ 目的 探讨Apgar评分与重度窒息新生儿心率变异性（HRV）的关联性。方法 选择2010-10～2014-05出生窒息的新生儿63例及健康新生儿40名作为观察对象，将所有新生儿的心电图进行24 h全程动态记录，对24 h窦性心律进行HRV时域分析，分析指标包括正常窦性心律RR间期标准差（SDNN）、每5 min RR间期平均值标准差（SDANN）、每5 min RR间期标准差平均值（SDNNindex）、相邻RR间期差值的均方根值（RMSSD）、正常RR间期标准差>50 ms的百分比（PNN50）。根据窒息新生儿出生后5 min Apgar评分，将所有窒息新生儿分为Apgar≤7分（重度窒息组21例），Apgar>7分（轻度窒息组42例）。所有新生儿于出生后第3天行动态心电图检查，对比HRV变化。结果 重度窒息组、轻度窒息组最慢心率、最快心率、平均心率显著低于健康对照组（P<0.05），而重度窒息组又显著低于轻度窒息组（P<0.05）；重度窒息组、轻度窒息组的SDNN、SDANN显著低于健康对照组（P<0.05），而重度窒息组又显著低于轻度窒息组（P<0.05）。结论 新生儿窒息会造成自主神经功能损伤，Apgar评分联合HRV时域参数可作为新生儿自主神经功能损伤判断的指标，可以较好地反映窒息缺氧严重程度。 |
| 关键词: Apgar评分 重度窒息新生儿 心率变异性 |
| DOI：10.3969/j.issn.1674-3806.2015.11.23 |
| 分类号:R 541.7 |
| 基金项目: |
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| Correlation between Apgar score and heart rate variability in newborns with severe asphyxia |
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LI Hong
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Teaching Group of Obstetrics and Gynecology Department, Longnan City Health School, Gansu 746000, China
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| Abstract: |
| ［Abstract］ Objective To analyze the correlation between Apgar score and heart rate variability(HRV) in newborns with severe asphyxia.Methods A total of 63 asphyxia newborns and 40 healthy newborns from October 2010 to May 2014 were selected as the study subjects. A 24 h entire dynamic recording of the cardiac function of all the newborns was performed, and time-domain analysis of HRV was performed for the 24 h sinus rhythm, with the normal sinus rhythm standard deviation of NN intervals(SDNN) as the analysis index. The standard deviation of average NN intervals(SDANN) in all 5-minute segments of the entire recording was recorded. The mean of the 5-minute standard deviation of NN intervals(SDNN index) and the root mean square successive difference(rMSSD) of adjacent NN intervals were recorded in the entire process. The percentage of standard deviation of NN intervals(PNN50) >50 ms was calculated. According to the 5 min Apgar score, all the asphyxia newborns were divided into severe group(Apgar≤7) and mild group(Apgar>7). Dynamic electrocardiogram was recorded for all the newborns on the third day after birth and the changes of HRV were compared.Results The maximum, minimum and average heart rates were significantly less in the severe group and the mild group than those in the healthy controls（P<0.05）, and those in the severe group were less than those in the mild grop（P<0.05）. SDNN and SDANN were significantly lower in the severe asphyxia group and the mild asphyxia group than those in the control group. SDNN and SDANN were significantly lower in the severe asphyxia group than those in the mild asphyxia group(P<0.05).Conclusion Neonatal asphyxia can cause impairment of autonomic nervous function. Apgar socre in combination with HRV time-domain indexes can evaluate the impairment of autonomic nervous function and reflects the hypoxia severity caused by asphyxia. |
| Key words: Apgar score Severe asphyxia newborns Heart rate variability |
