~1H-MRS在足月新生儿缺氧缺血性脑病中的应用及其与NBNA评分的相关性

发布时间：2018-06-20 09:23

本文选题：婴儿 + 新生　；参考：《宁夏医科大学》2014年硕士论文

【摘要】：目的分析足月新生儿氢质子磁共振波谱(~1H-MRS)脑组织各代谢产物的变化,评估其在足月新生儿缺氧缺血性脑病(hypoxic-ischemic encephalopathy,HIE)中的临床应用价值。探讨足月新生儿缺氧缺血性脑病(HIE)~1H-MRS指标与临床NBNA评分的相关性。方法纳入足月HIE患儿101例,29例日龄72 h、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。对所有新生儿行常规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(N-acetylaspartate,NAA)/胆碱复合物(choline,Cho)、NAA/肌酸(creatine Cr)及Cho/Cr差异;对HIE患儿行新生儿行为神经测定(neonatal behavioral neurological assessment,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。结果不同日龄中重度HIE患儿基底节NAA/Cho和NAA/Cr、额叶NAA/Cho均低于相应日龄正常新生儿,(P均0.05)。不同日龄重度HIE患儿NBNA评分均低于中度HIE患儿,差异有统计学意义(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评分显著相关,二者结合有助于早期检出足月HIE患儿及评价脑损伤严重程度。
[Abstract]:Objective to analyze the changes of metabolites in brain tissue of full-term neonates with proton magnetic resonance spectroscopy (1H-MRS) and to evaluate their clinical value in the diagnosis of hypoxic-ischemic encephalopathy (HIEE) of term neonates. To investigate the correlation between 1H-MRS and clinical NBNA score in term neonates with hypoxic ischemic encephalopathy (HIE). Methods A total of 101 children with full-term HIE were enrolled in this study. Among them, 29 cases were 72 hours old, 33 cases were 4 days old, 7 days old, 39 cases were 8 days old and 14 days old, and 37 healthy newborns in the same period were selected as normal control. All neonates were examined with conventional Mr and 1H-MRS. According to the MRI findings, HIE was graded to compare the difference of NAAA / creatine Cr (NAAA / creatine Cr) and Chorcr in NacetylaspartateNacetylaspartate / choline complex (N-acetylaspartate NAA / choline complex) with different degrees of HIE and normal neonates. To evaluate the correlation between NBNA score and neonatal behavioral nerve test (NBNA) score, to compare the difference of NBNA score in different degree of HIE children, and to evaluate the correlation between 1H-MRS index and NBNA score. Results NAA / Cho and NAA / Cr in basal ganglia and NAA / Cr in frontal lobe of children with moderate and severe HIE at different days were lower than those in normal neonates of corresponding day age (P < 0.05). The NBNA scores of severe HIE children at different ages were lower than those of moderate HIE children. The difference was statistically significant (P < 0.05). There was a positive correlation between NAA / Cho and NAA- / Cr in basal ganglia, and a positive correlation between NAA / Cho and NBNA scores in frontal lobe NAA / Cho and NBNA scores in HIE children (P < 0.05). The combination of the two methods is helpful for early detection of term HIE and evaluation of the severity of brain injury.
【学位授予单位】：宁夏医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R742;R445.2

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