中国现代医学杂志2017，Vol.27Issue(18)：110-114,5.DOI:10.3969/j.issn.1005-8982.2017.18.023
新生儿缺氧缺血性脑损伤的磁共振成像波谱分析
Analysis of magnetic resonance imaging spectrum in neonates with hypoxic ischemic brain damage
摘要
Abstract
Objective To discuss the application of magnetic resonance imaging spectrum (MRS) in neonatal hypoxic ischemic brain damage.Methods Totally 180 children administrated in our hospital form September 2013 to September 2016 with diagnosis of neonatal hypoxic ischemic brain damage were selected.The patients were divided into mild group (n =90),moderate group (n =50) and severe group (n =40) based on the severity.Also the patients were divided into survival group (n =150) and death group (n =30) based on 28-day observation.All newborns received magnetic resonance spectroscopy of glycine and pancreatic phthalein compounds (CLx-α),N-acetyl aspartate (NAA),choline (Cho),creatine (Cr) and lactic acid (Lac).ROC curve analyses of CLx-α/Cr and Lac/Cr values were performed to predict the prognosis of newborn children.Results In the aspect of NAA/Cr and NAA/Cho values,children from the mild group had dramatically higher levels than those of the moderate group;so did the newborns from the moderate group when compared to those from the severe group.In terms of CLx-oα/Cr and Lac/Cr values,the children from the mild group had significantly lower levels than those of the moderate group;so did the newborns from the moderate group when compared to those from the severe group (P ＜ 0.05).The children from the survival group experienced markedly lower levels of CLx-α/Cr and Lac/Cr when compared to those in the deceased group (P ＜ 0.05).ROC curve analysis results showed that with the cutting edge of CLx-α/Cr value as 1.35,the sensitivity,specificity and accuracy to predict the death of children were 86.67％,90.00％ and 89.44％ respectively.With the cutting edge of Lac/Cr as 1.35,the sensitivity,specificity and accuracy to predict the death of children were 83.33％,88.00％ and 87.22％ respectively.Synergistic efficacy of CLx-α/Cr and Lac/Cr to predict the death was significantly higher (P ＜ 0.05),with the sensitivity,specificity and accuracy as 93.33％,97.33％ and 97.78％ respectively.Conclusions MRS technique can noninvasively monitor metabolic changes in the patients with hypoxic ischemic brain damage.Application of CLx-α/Cr combined with Lac/Cr can predict prognosis of children,it's worth further clinical promotion.关键词
新生儿/缺氧缺血性脑损伤/磁共振成像波谱/病情/预后Key words
newborn/hypoxic-ischemic brain damage/magnetic resonance imaging spectroscopy/condition/prognosis分类
医药卫生引用本文复制引用
刘兵,杜乃熠,张钊,赵树军,康志雷..新生儿缺氧缺血性脑损伤的磁共振成像波谱分析[J].中国现代医学杂志,2017,27(18):110-114,5.基金项目
河北省指令性课题计划(No:ZL20140001) （No:ZL20140001）
