| 杜奕,李艳,陈志强,刘玲玲,李鹏,田淑萍,吴玉华,陈兵,金国宏,杨文君.足月缺氧缺血性脑病患儿1H-MRS与新生儿神经行为测定评分的相关性[J].中国医学影像技术,2014,30(6):822~826 |
| 足月缺氧缺血性脑病患儿1H-MRS与新生儿神经行为测定评分的相关性 |
| Correlation between 1H-MRS and neonatal behavioral neurological assessment score in full-term neonates with HIE |
| 投稿时间：2014-02-21 修订日期：2014-03-28 |
| DOI： |
| 中文关键词: 婴儿,新生儿 缺氧缺血,脑 磁共振波谱 NBNA评分 |
| 英文关键词:Infant,newborn Hypoxia-ischemia,brain Magnetic resonance spectroscopy NBNA score |
| 基金项目:银川市科技攻关资助项目（W2011019）、宁夏医科大学面上项目（XM2012）。 |
| 作者 | 单位 | E-mail | | 杜奕 | 宁夏医科大学, 宁夏 银川 750004 | | | 李艳 | 宁夏医科大学, 宁夏 银川 750004 | | | 陈志强 | 宁夏医科大学总医院放射科, 宁夏 银川 750004 | czq642000@163.com | | 刘玲玲 | 宁夏医科大学, 宁夏 银川 750004 | | | 李鹏 | 宁夏医科大学总医院放射科, 宁夏 银川 750004 | | | 田淑萍 | 宁夏医科大学总医院新生儿科, 宁夏 银川 750004 | | | 吴玉华 | 宁夏医科大学总医院新生儿科, 宁夏 银川 750004 | | | 陈兵 | 宁夏医科大学总医院放射科, 宁夏 银川 750004 | | | 金国宏 | 宁夏医科大学总医院放射科, 宁夏 银川 750004 | | | 杨文君 | 宁夏医科大学生育力保持教育部重点实验室, 宁夏 银川 750004 | ywjo_o@126.com |
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| 中文摘要: |
| 目的 探讨足月缺氧缺血性脑病（HIE）患儿1H-MRS与NBNA评分的相关性。方法 纳入足月HIE患儿101例，29例日龄≤3天、33例日龄4~7天、39例日龄8~14天；另选取同期足月健康新生儿37名作为正常对照。行常规MR及1H-MRS检查，根据MRI表现对HIE进行分级，比较不同程度HIE患儿和正常新生儿N-乙酰天门冬氨酸（NAA）/胆碱复合物（Cho）、NAA/肌酸（Cr）及Cho/Cr差异；对HIE患儿行新生儿行为神经测定（NBNA）评分，比较不同程度HIE患儿NBNA评分差异；评价1H-MRS指标与NBNA评分的相关性。结果 ≤3天重度HIE患儿，4~7天和8~14天中、重度患儿基底节NAA/Cho低于相应日龄正常新生儿（P均<0.05），所有日龄中、重度HIE患儿基底节NAA/Cr和额叶NAA/Cho均低于相应日龄正常新生儿（P均<0.05）；≤3天和8~14天不同程度HIE患儿间基底节NAA/Cho、4~7天不同程度HIE患儿间额叶NAA/Cho差异有统计学意义（P均<0.05）。不同日龄重度HIE患儿NBNA评分均低于中度HIE患儿（P均<0.05）。HIE患儿基底节NAA/Cho和NAA/Cr、额叶NAA/Cho与NBNA评分呈正相关（r=0.238，0.221，0.202；P均<0.05）。结论 HIE患儿1H-MRS与NBNA评分具有相关性，二者结合有助于早期检出足月儿HIE及评价脑损伤严重程度。 |
| 英文摘要: |
| Objective To investigate the correlation between 1H-MRS and neonatal behavioral neurological assessment (NBNA) score in full-term neonates with hypoxic-ischemic encephalopathy (HIE). Methods Totally 101 neonates with HIE were enrolled, among whom, 29 was ≤3 days, 33 was 4—7 days and 39 was 8—14 days. In addition, 37 healthy neonates at the same period were enrolled as normal controls. Routine MRI and 1H-MRS examination were performed, and HIE were graded according to MRI findings. N-acetylaspartate (NAA)/choline (Cho), NAA/creatine (Cr) and Cho/Cr in neonates of different grades of HIE and healthy neonates were compared. NBNA was conducted on HIE neonates and compared among neonates with HIE of different grades. The correlation between 1H-MRS and NBNA score in full-term neonates with HIE were analyzed. Results NAA/Cho of the basal ganglia in severe HIE neonates of ≤3 days, moderate and severe HIE neonates of 4—7 days and 8—14 days were all lower than that in healthy neonates (all P<0.05). NAA/Cr of the basal ganglia and NAA/Cho of the frontal lobe in all HIE neonates were lower than those in healthy neonates (all P<0.05). NAA/Cho of the basal ganglia in neonates of ≤3 days and 8—14 days, and NAA/Cho of the frontal lobe in neonates of 4—7 days were found to be different between moderate and severe HIE (all P<0.05). In neonates of different days of age, NBNA score of severe HIE was lower than that of moderate HIE. NAA/Cho and NAA/Cr of the basal ganglia and NAA/Cho of the frontal lobe were positively correlated with NBNA score in HIE neonates (r=0.238, 0.221, 0.202, all P<0.05). Conclusion 1H-MRS is correlated with NBNA score in HIE neonates, which is helpful to early detecting HIE in full-term neonates and evaluating the extent of brain injury. |
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