新生儿缺氧缺血性脑病豆纹动脉血流变化与脑损伤程度的关系

Relationship between the changes in blood flow of lenticulostriate artery and the degree of brain injury in neonatal hypoxic-ischemic encephalopathy

目的探讨豆纹动脉血流参数变化对评估新生儿缺氧缺血性脑病(HIE)的临床价值。方法选择2018年1月至2020年2月我院收治的HIE患儿80例为观察组,其中轻度患儿32例,中度22例,重度26例。同期选择健康新生儿40例为对照组。分别于出生后24 h、48 h及72 h测量豆纹动脉的收缩期峰值流速(Vs)、舒张末期速度(Vd)、阻力指数(RI)变化。结果生后24 h后,观察组HIE患儿豆纹动脉的Vs、Vd均明显低于对照组,RI显著升高,差异有统计学意义(P<0.05),且轻度与中、重度HIE组之间Vs、Vd及RI比较差异有统计学意义(P<0.05),中度与重度HIE组Vs、Vd及RI比较差异无统计学意义(P>0.05)。48 h、72 h后轻度及中度HIE组患儿Vs、Vd及RI接近或恢复正常(P>0.05),重度HIE组患儿Vs、Vd仍低于对照组及轻、中度HIE组,且RI持续升高,差异有统计学意义(P<0.05)。结论豆纹动脉脑血流参数变化对评估HIE患儿脑损伤程度有重要的临床价值,可为临床早期干预提供影像学依据。

Objective To study the clinical value of the changes in blood flow parameters of lenticulostriate artery in the evaluation of neonates with hypoxic-ischemic encephalopathy(HIE).Methods A total of 80 children with HIE treated in our hospital from Jan.2018 to Feb.2020 were included as the observation group,among whom 32 were mild,22 were moderate and 26 were severe.During the same period,40 healthy neonates were chosen as the control group.The changes in peak systolic velocity(Vs),end-diastolic velocity(Vd)and resistance index(RI)of lenticulostriate artery at 24h,48h and 72h after birth were determined.Results At 24h after birth,the Vs and Vd of lenticulostriate artery in HIE children of observation group were significantly lower than those in control group,and RI was significantly increased compared with control group,the differences being statistically significant(P<0.05).There were also statistical differences in Vs,Vd and RI between mild HIE children and moderate and severe HIE children(P<0.05).There was no statistical difference in Vs,Vd or RI between moderate groups and severe group(P>0.05).At 48h and 72h after birth,the Vs,Vd and RI in mild and severe HIE children were close to normal or completely normal(P>0.05),while they were still lower in severe group than in mild,moderate and control group,and RI was continuously increasing,the differences being of statistical significance(P<0.05).Conclusion The changes in blood flow parameters of lenticulostriate artery have significant clinical value in the evaluation of brain injury in HIE children,which can provide imaging evidence for early clinical intervention.