^1H-MRS评价新生儿缺氧缺血性脑病

1H-MRS in evaluation of hypoxic-ischemic encephalopathy on neonates

目的 探讨^1 H-MRS评价新生儿缺氧缺血性脑病（HIE）的价值。方法 收集经临床确诊的足月HIE患儿30例（HIE组）和无神经系统异常新生儿16例（对照组）。于出生后22天内行头颅^1 H-MRS扫描,分别计算胆碱/肌酸（Cho/Cr）、N-乙酰天门冬氨酸/肌酸（NAA/Cr）、N-乙酰天门冬氨酸/胆碱（NAA/Cho）、乳酸/肌酸（Lac/Cr）比值,并进行统计学分析。结果 与对照组比较,HIE组Lac/Cr升高（P〈0.05）,NAA/Cr,NAA/Cho均降低（P均〈0.05）,Cho/Cr差异无统计学意义（P〉0.05）。多因素Logistic回归分析结果示NAA/Cr、Lac/Cr是HIE的独立危险因素（P均〈0.05）。结论^1 H-MRS可客观反映HIE患儿缺氧缺血后代谢变化,更好地评价脑损伤的严重程度,有助于HIE的早期诊断及治疗。

Objective To explore the value of 1H-MRS in evaluation of hypoxic-ischemic encephalopathy （HIE） in neo- nates. Methods Totally 30 full-term neonates with HIE confirmed by clinic （HIE group） and 16 infants without nervous system abnormalities （control group） were collected. Cerebral 1 H-MRS was performed within 22 days after birth. Choline/ creatine （Cho/Cr）, N-acetylaspartate/creatine （NAA/Cr）, N-acetylaspartate/choline （NAA/Cho）, lactic acid/creatine （Lac/Cr） were canculated respectively, and statistical analysis was carried out. Resluts Compared to control group, Lac/ Cr in HIE group was statistically increased （P〈0.05）, and NAA/Cr, NAA/Cho were both statistically decreased （both P P〈0.05）. The difference of Cho/Cr between 2 groups had no statistical significance （P〉0.05）. Logistic regression analy- sis showed NAA/Cr and Lac/Cr were independent risk factors of HIE （both P〈0.05）. Conclusion 1 H-MRS can objec- tively reflect brain metabolic changes of HIE, and it is a usful method to evaluate brain injury.