围生期窒息对不同胎龄新生儿生化指标和颅脑CT的影响

Effect of Perinatal Asphyxia on Levels of Biochemical Parameters and Brain CT Imaging Findings in Infants of Different Gestational Age

目的探究围生期窒息对不同胎龄新生儿血生化指标水平和颅脑CT影像表现的影响。方法回顾性分析2015年3月-2017年3月因围生期窒息于我院NICU接受治疗的68例新生儿的临床资料。依据窒息程度将患儿分为重度窒息组32例(足月儿18例,早产儿14例)和轻度窒息组36例(足月儿21例,早产儿15例),选择同时期33例健康新生儿为对照组(足月儿17例,早产儿16例)。采集3组新生儿静脉血,测定血清谷草转氨酶(AST)、α-羟丁酸脱氢酶(α-HBDH)、胰岛素样生长因子(IGF-1)浓度,比较上述生化指标水平差异;所有新生儿均行颅脑CT检查,并对图像进行分析。结果足月儿血清AST、α-HBDH水平:重度窒息组﹥轻度窒息组﹥对照组(P<0.05),早产儿重度窒息组、轻度窒息组血清AST、α-HBDH水平高于对照组(P<0.05),足月儿、早产儿血清IGF-1水平:重度窒息组<轻度窒息组<对照组(P<0.05)。窒息患儿颅脑CT图像可见脑实质不同程度的低密度灶,部分合并出血灶。结论不同胎龄不同窒息程度的新生儿血清生化指标水平和颅脑CT影像表现存在明显差异性,可作为诊断新生儿窒息的有效指标。

Objective To explore the effect of perinatal asphyxia on levels of blood biochemical parameters and brain CT imaging findings in infants of different gestational age.Methods The clinical data of 68 infants treated in NICU of our hospital because of perinatal asphyxia during the period from March 2015 to March 2017 were retrospectively analyzed.According to the degree of asphyxia,the infants were divided into the severe asphyxia group(32 cases,including 18 term infants and 14 premature infants)and the mild asphyxia group(36 cases,including 21 term infants and 15 premature infants).33 healthy infants were selected as the control group(17 term infants and 16 premature infants).The neonatal venous blood of three groups was collected to determine concentrations of serum aspartate aminotransferase(AST),α-hydroxybutyrate dehydrogenase(α-HBDH)and insulin-like growth factor(IGF-1),and levels of above-mentioned biochemical indexes were compared.All infants were examined with brain CT and images were analyzed.Results Levels of serum AST andα-HBDH in term infants showed the severe asphyxia group>the mild asphyxia group>the control group(P<0.05).The levels in premature infants in the severe asphyxia and the mild asphyxia group were higher than those in the control group(P<0.05).Serum IGF-1 levels in term infants and premature infants showed the severe asphyxia group<the mild asphyxia group<the control group(P<0.05).The brain CT images of infants with asphyxia showed different degrees of low-density foci of brain parenchyma,and some of them were complicated with hemorrhagic foci.Conclusion There ere obvious differences in levels of serum biochemical parameters and brain CT imaging findings in infants of different gestational age and with different degrees of asphyxia.They can be used as effective indexes for diagnosis of neonatal asphyxia.