新生儿急性胆红素脑病苍白球^(1)H-MRS信号特点及其与预后的相关性研究

Characteristics of ^(1)H-MRS Signal in the Globus Pallidus of Neonates with Acute Bilirubin Encephalopathy and its Correlation with Prognosis

目的回顾性分析新生儿急性胆红素脑病双侧苍白球^(1)H-MRS信号特点及其与预后的相关性,为临床早期诊断急性胆红素脑病、评估预后提供依据。方法回顾性分析2014年3月至2020年3月在我院及同济医院新生儿科住院的病理性黄疸患儿,依据临床表现及颅脑MRI检查结果分为观察组(急性胆红素脑病组)、对照组(无脑损伤组),两组各50例。分析观察组和对照组波谱扫描谱线峰值的信号特点。结果^(1)HMRS所见:观察组患儿NAA/Cr、NAA/Cho较对照组明显减小(P<0.05);观察组双侧苍白球谱线峰值Glx/Cr、mI/Cr较对照组明显升高(P<0.05);两组间谱线峰值Cho/Cr差异无统计学意义(P>0.05)。结论^(1)HMRS扫描可更早反映急性胆红素脑病患儿神经元细胞及轴突的代谢异常,为临床早期诊断、早期治疗及预后评估提供依据。

Objective The ^(1)HMRS signal characteristics of bilateral globus pallidus in neonates with acute bilirubin encephalopathy and their correlation with prognosis were retrospectively analyzed to provide evidence for early clinical diagnosis of acute bilirubin encephalopathy and evaluation of prognosis.Methods Children with pathological jaundice who were hospitalized in our hospital and Tongji Hospital’s Neonatology Department from March 2014 to March 2020 were retrospectively analyzed,and were divided into observation group(acute bilirubin encephalopathy group),The control group(no brain injury group),50 cases in each group,and the signal characteristics of the peaks of spectral scanning lines in the observation group and the control group were analyzed.Results ^(1)HMRS findings showed that NAA/Cr and NAA/Cho in the observation group were significantly lower than those in the control group(P<0.05).The peak GLX/Cr and MI/CR of bilateral pallidocytes in the observation group were significantly higher than those in the control group(P<0.05).There was no significant difference in peak Cho/Cr between the two groups(P>0.05).Conclusion ^(1)HMRS scans can reflect the metabolic abnormalities of neuronal cells and axons in children with acute bilirubin encephalopathy earlier,and provide a basis for early clinical diagnosis,early treatment and prognosis evaluation.