新生儿缺氧缺血性脑病神经发育预后的影响因素

Predictive factors for prognosis of neurodevelopment in term neonates with hypoxic ischemic encephalopathy

目的 探讨足月新生儿缺氧缺血性脑病神经发育预后的相关危险因素.方法 50例HIE足月患儿出院后44～～48月行脑电图、影像学检查、神经系统相关检查和神经发育评分,将死亡和发育异常者归为预后不良组,发育正常者归为预后良好组.Logistic回归分析影响神经发育预后的危险因素.结果 脑电图异常程度、颅脑成像异常程度（头颅MRI等）以及神经发育评分与足月新生儿缺氧缺血性脑病神经发育预后密切相关.结论 脑电图异常程度、颅脑成像异常程度（头颅MRI等）以及神经发育评分是评估足月新生儿缺氧缺血性脑病神经发育的重要参考指标.

Objective To explore predictive factors to evaluate the neurodevelopmental prognosis in term neonates with hypoxic-ischemic encephalopathy（HIE）.Methods Electroencephalography,neuroimaging,periodic neurological exams and a developmental test at 44-48months after discharge from the hospital were performed on 50 term neonates with HIE.The dead and abnormally developed neonates were taken as problematic prognosis group,and well developed neonates taken as good prognosis group.Logistic analysis was made of risk factors affecting neurodevelopmental prognosis.Results Normal/mildly abnormal neonatal electroencephalography was correlated with favorable outcome,particularly if neuroimaging was normal.The cranial MRI sensitivity and specificity was higher,and the predictive value was higher.Moderate/severely abnormal electroencephalography and multifocaI/diffuse cortical or deep gray matter lesions were correlated with poor outcomes.Conclusion Neurological developmental scores,abnormal electroencephalogram and brain imaging are predictive risk factors to evaluate the neurodevelopmental prognosis in term neonates with HIE.