核磁共振成像联合血清学检测在新生儿缺血缺氧性脑病诊断中的意义及应用价值

Significance and application value of detection of magnetic resonance imaging combined with serological test in diagnosis of neonatal hypoxic ischemic encephalopathy

目的:探讨核磁共振成像(MRI)联合血清学检测在新生儿缺血缺氧性脑病诊断中的意义及应用价值。方法:随机选取50例经临床诊断为缺血缺氧性脑病的新生儿作为研究对象,采用3.0T MRI检测及患儿血清学酶联免疫法对缺氧诱导因子-1(HIF-1)检测。结果:依据MRI的影像特点,将50例缺血缺氧性脑损伤患儿分为单纯性脑水肿9例、广泛性脑水肿伴基底节损伤11例、局灶性脑水肿伴基底节损伤13例、脑出血及蛛网膜下腔出血22例;各组病例对应的HIF-1蛋白水平检测由高到低依次为脑出血及蛛网膜下腔出血组、广泛性脑水肿伴基底节损伤组、局灶性脑水肿伴基底节损伤组、单纯性脑水肿组,组间差异有统计学意义(P<0.05)。结论:MRI对新生儿缺血缺氧性脑病诊断十分敏感,配合HIF-1蛋白水平检测有助于临床用药的治疗指导和预后的评估。

Objective: To explore the significance and application value of magnetic resonance imaging( MRI) combined with serological test in diagnosis of neonatal hypoxic ischemic encephalopathy( HIE). Methods: Fifty neonates diagnosed as HIE were randomly selected as research objects,3. 0T MRI and serological ELISA were used to detect hypoxia inducible factor- 1( HIF- 1). Results: According to the image characteristics of MRI,50 neonates with HIE were divided into pure cerebral edema group( 9 neonates),diffuse brain edema combined with basal ganglia injury group( 11 neonates),focal cerebral edema combined with basal ganglia injury group( 13 neonates),cerebral hemorrhage and subarachnoid hemorrhage injury group( 22 neonates); HIF- 1 protein levels from high to low were cerebral hemorrhage and subarachnoid hemorrhage injury group,diffuse brain edema combined with basal ganglia injury group,focal cerebral edema combined with basal ganglia injury group and pure cerebral edema group,there was statistically significant difference among the four groups( P < 0. 05). Conclusion: MRI is very sensitive to diagnosis of neonatal HIE,MRI combined with detection of HIF- 1 protein level contributes to directing clinical medication and prognosis evaluation.