应用近红外光谱技术评价早产儿认知功能的探讨

Evaluation of early cognitive ability of infants born preterm by near-infrared spectroscopy

目的通过建立对早产儿光刺激后的反应模式,评价早产儿早期的认知功能,研究早产儿在发育过程中的脑反应性与足月儿之间的差距。方法对纠正胎龄3个月、6个月的早产儿进行光刺激,应用近红外光谱技术,观察光刺激后脑反应性的变化,并与同龄儿对照。结果早产儿在纠正胎龄3个月时,光刺激后开始反应时间、反应高峰出现的时间分别为17.2±5.2s、38.4±9.6s,明显长于足月儿的13.1±2.7s、28.9±5.0s;脑组织还原血红蛋白、氧合血红蛋白、脑组织氧饱和度在刺激后的最大反应值分别为(1.2±0.5)%、(1.5±0.6)%、(1.3±0.4)%,明显低于足月儿的(2.3±0.3)%、(2.8±0.3)%、(2.4±0.5)%。到了纠正胎龄6个月时,光刺激后的脑反应性与足月儿相比,无统计学差异。结论早产儿在发育过程中,认知功能存在一定的滞后,到纠正胎龄3个月时,外界刺激后的脑反应性仍落后于同龄儿,到了纠正胎龄6个月时,脑反应性接近同龄儿,应加强对早产儿的早期干预。

Objective To compare the differences in cerebral oxygenation responses between the infants born preterm and full-term infants and to evaluate the early cognitive ability of infants born preterm. Methods Cerebral oxygenation after light stimulation was detected by near infrared spectroscopy （ NIRS ） in preterm infants at 3 or 6 months corrected gestational age （GA）, The results were compared with those of age-matched infants born at term. Results The start and peak response time of cerebral oxygenation occurring after light stimulation in preterm infants at 3 months corrected GA was 17.2 ±5.2 and 38.4 ±9.6 seconds respectively, which were significantly longer than in age-matched term infants （ 13.1 ± 2.7 and 28.9 ± 5.0 seconds respectively） （P 〈 0.05 ）. The maximum response value of hemoglobin, oxyhemoglobin and regional oxygen saturation of the preterm infants at 3 months corrected GA was （ 1.2 ± 0.5 ） %, （ 1.5 ± 0.6） % , and （ 1.3± 0.4 ） % respectively , which were significantly lower than that of the term infants [ （ 2.3 ± 0.3 ） % , （ 2.8 ± 0.3 ） % and （ 2.4 ± 0.5 ） % respectively ] （ P 〈 0.05 ）. Cerebral oxygenation responses to light stimulation in preterm infants examined at 6 months corrected GA were not significantly different from age-matched term infants. Conclusions Cerebral oxygenation responses to light stimulation in infants born preterm at 3 months corrected GA are not as good as age-matched term infants, but were close to the level of age-matched term infants at 6 months corrected GA. This suggests that the early cognitive ability of preterm infants before 3 months corrected GA might fall behind age-matched term infants.