高频及低频超声联合应用评估新生儿脑发育与孕周、出生体质量关系的价值探讨

Evaluating on the relationship between neonatal brain development and gestational week,birth weight by high frequency and low frequency ultrasound

目的联合应用高频及低频超声评估新生儿脑发育与孕周及出生体质量的关系,探讨其在评估新生儿脑发育中的临床价值。方法100例新生儿根据出生时孕周分为4组,A组4例(孕29~32周),B组18例(孕32~34周),C组20例(孕34~36周),D组58例(孕36周以上)。所有新生儿均行高低频超声检查,比较各组新生儿出生体质量、不同区域脑组织超声平均灰度值、胼胝体及小脑蚓部长度,并对孕周和出生体质量与胼胝体及小脑蚓部长度、不同区域脑组织超声平均灰度值进行相关性分析。结果除B、C组新生儿出生体质量比较差异无统计学意义外,其余各组两两比较差异均有统计学意义(均P<0.05)。各组新生儿丘脑基底节、额叶白质、枕叶白质平均灰度值及胼胝体、小脑蚓部长度比较差异均有统计学意义(均P<0.05),胼胝体及小脑蚓部长度从小到大均依次为A组、B组、C组及D组,不同区域脑组织超声平均灰度值从小到大依次为D组、C组、B组、A组,差异均有统计学意义(均P<0.05)。相关性分析显示,孕周与丘脑基底节、额叶白质、枕叶白质平均灰度值均呈负相关(r=-0.551、-0.529、-0.499,均P<0.05);出生体质量与丘脑基底节、额叶白质、枕叶白质平均灰度值均呈负相关(r=-0.672、-0.608、-0.529,均P<0.05)。孕周与胼胝体矢状长度、小脑蚓部矢状长度均呈正相关(r=0.670、0.640,均P<0.05);出生体质量与胼胝体矢状长度、小脑蚓部矢状长度均呈正相关(r=0.630、0.650,均P<0.05)。结论高频及低频超声联合应用可为临床评估新生儿脑发育提供可靠依据,具有较好的应用价值。

Objective To evaluate the relationship between neonatal brain development and gestational week,birth weight by combination of high frequency and low frequency ultrasound,and to explore its clinical value in evaluation of neonatal brain development.Methods According to the gestational age of birth,100 newborns were divided into 4 groups,group A:29~32 gestational weeks(4 cases),group B:32~34 gestational weeks(18 cases),group C:34~36 gestational weeks(20 cases),group D:≥36 gestational week(58 cases).Ultraosund examination were performed on all newborns.The birth weight,average gray value of ultrasound of brain tissue in different regions,length of corpus callosum and cerebellum vermis in each group were compared,and correlation analysis was carried out between gestational weeks,birth weight and length of corpus callosum and cerebellum vermis,and average gray value of ultrasound of brain tissue in different regions.Results Except that there was no significant difference in birth weight between group B and group C,there was significant difference in other groups(all P<0.05).The average gray values of thalamic basal ganglia,frontal lobe white matter and occipital lobe white matter,and the lengths of corpus callosum and cerebellum vermis in each group were statistically significant(all P<0.05).The lengths of corpus callosum and cerebellum vermis in groups A^D were from low to high.The average gray value of brain tissue ultrasound in different regions of group D^A was from low to high.The difference was significant(all P<0.05).Correlation analysis showed that the gestational age were significantly negatively correlated with the average gray value of the basal ganglia,frontal white matter and occipital white matter(r=-0.551,-0.529,-0.499,all P<0.05),and the birth weight were significantly negatively correlated with length of the corpus callosum and the length of the cerebellum(r=-0.672,-0.608,-0.529,all P<0.05).The gestational age and birth weight were positively correlated with the length of corpus callosum and cerebellum vermis(r=0.670,0.640,0.630,0.650,all P<0.05).Conclusion Combination of high frequency and low frequency ultrasound can provide reliable basis for clinical evaluation of neonatal brain development and has good application value.