当前位置:首页 > 行业资讯 > 临床快报 > 小儿科 > 睡眠时的血压变化可能与SIDS有关


来源:WebMD 作者:Laurie Barclay, MD 2008-12-19
336*280 ads

摘要: 根据发表于12月小儿科期刊的研究结果,睡眠时的血压变化可能与发生婴儿猝死症(SIDS)有关。 Witcombe等人写道,早产婴儿的SIDS风险增加,可能是因为心律与血压自体控制不成熟。之前的研究显示,早产婴儿的心律和血压与校正年龄组不一样。本研究的目标是确认早产者在出生后6个月内、与达到校正年龄后之心律与血压,包括增加......

  澳洲Monash大学Ritchie婴儿健康研究中心的Nicole B. Witcombe等人写道,早产婴儿的SIDS风险增加,可能是因为心律与血压自体控制不成熟;之前的研究显示,早产婴儿的心律和血压与校正年龄组不一样;不过,有关这个年纪的资讯有限。本研究的目标是确认早产者在出生后6个月内、与达到校正年龄后之心律与血压,包括增加SIDS风险的年纪,以了解SIDS的病理。
  研究针对25个早产儿和20个周产儿在2至4周、2至3个月、5至6个月校正年龄时进行日间多频道睡眠记录;在婴儿的手腕运用光体积描绘图讯号(Finometer, Finapres Medical Systems BV公司) 测量安静与活动睡眠时的血压。

Blood Pressure Changes During Sleep May Be Related to SIDS

By Laurie Barclay, MD
Medscape Medical News

Blood pressure changes during sleep may be related to development of sudden infant death syndrome (SIDS), according to the results of a study published in the December issue of Pediatrics.

"Preterm infants are at an increased risk of , which may result from immature autonomic control of heart rate and blood pressure," write Nicole B. Witcombe, BSc, from the Ritchie Centre for Baby Health Research at Monash University in Melbourne, Victoria, Australia, and colleagues. "Previous studies have demonstrated that preterm infants have altered heart rate and blood pressure control at term-equivalent age; however, little information is available beyond this age. The aim of this study was to determine the effect of preterm birth on heart rate and blood pressure control over the first 6 months of life after reaching term-equivalent age, including the age at which risk is increased, to understand the pathogenesis of ."

Daytime polysomnography was performed in 25 preterm and in 20 term infants at 2 to 4 weeks, 2 to 3 months, and 5 to 6 months of term-corrected age. A photoplethysmographic cuff (Finometer, Finapres Medical Systems BV) applied around the infant's wrist measured blood pressure during quiet and active sleep.

At all ages studied, the preterm group had lower blood pressure during both quiet and active sleep, but heart rate did not differ between groups. For the infants in the preterm group, average blood pressure was lower at 2 to 3 months' corrected age than at 2 to 4 weeks' and 5 to 6 months' corrected age and was lower in quiet sleep than in active sleep at all ages studied. Heart rate decreased with increasing age. At 5 to 6 months' corrected age, heart rate was lower in quiet sleep than in active sleep.

"Sleep state and age affect heart rate and blood pressure patterns in prematurely born infants over the first 6 months of term-corrected age," the study authors write. "It is notable that preterm infants had persistently lower blood pressure compared with age-matched term infants, signifying long-term alterations in cardiovascular control in infants born prematurely."

Limitations of this study include heterogeneity of the study sample; that 3 of the 25 infants studied were born small for gestational age; and matching of term and preterm infants for conceptual age, even though the period of peak SIDS risk in preterm infants occurs at an earlier conceptual age than the 2 to 3 months' age studied.

"We identified significant differences in [blood pressure] between preterm and term infants that may contribute to the increased risk of SIDS in preterm infants," the study authors conclude. "Additional studies examining baroreflex responses and cardiovascular variability during sleep are required to further understand whether preterm infants have impaired cardiovascular control during the early postnatal period. These studies may further explain the mechanisms involved in the increased risk for SIDS associated with preterm birth and the impact that this may have on the cardiovascular system later in life."

The National Health and Medical Research Council of Australia supported this study. The authors have disclosed no relevant financial relationships.

Pediatrics. 2008;122:e1242–e1248.






网站地图 | RSS订阅 | 图文 | 版权说明 | 友情链接
Copyright © 2008 39kf.com All rights reserved. 医源世界 版权所有