头颅彩色多普勒成像在高危儿神经监测中的评估作用

Role of Cranial Color Doppler Imaging in Neurological Evaluation in High-Risk Infants

目的验证大脑前、中动脉血流频谱和阻力指数(RI)在高危儿神经监测中的作用。方法选取在高危儿门诊就诊的有高危因素婴儿(研究组)和无高危因素婴儿(对照组),其中,0~3月龄研究组74例,对照组78例;>3~6月龄研究组和对照组均为46例。所有研究对象均行头颅彩色多普勒超声常规扫描和频谱多普勒扫描检查,测量大脑前动脉和中动脉的收缩期峰值速度(PSV)和RI值,同时进行20项神经运动检查和发育筛查。结果0~3月龄大脑前动脉PSV值研究组低于对照组、RI值研究组高于对照组(P<0.05),大脑中动脉PSV值和RI值研究组均高于对照组(P<0.05);20项神经运动测试结果研究组异常率(69%)高于对照组(46%)(P<0.05)。>3~6月龄大脑前动脉及大脑中动脉PSV及RI研究组均低于对照组(P<0.05);20项神经运动测试结果研究组异常率(67%)高于对照组(24%)(P<0.05),发育筛查结果研究组异常率(78%)高于对照组(30%)(P<0.05)。结论在0~3月龄的高危儿神经发育监测中,大脑前动脉PSV与神经发育监测结果有一定关联性;在>3~6月龄的高危儿神经监测中大脑前动脉及大脑中动脉PSV及RI均有参考意义。

Objective To verify the role of anterior and middle cerebral artery blood flow spectrum and resistive index(RI)in neurological monitoring in high-risk infants.Methods Infants with high risk factors(study group)and infants without high risk factors(control group)attending the high-risk infant clinics were selected,including 74 infants aged 0-3 months and 46 infants aged>3-6 months in the study group,and 78 infants aged 0-3 months and 46 infants aged>3-6 months in the control group.Routine cranial color Doppler ultrasonography and spectral Doppler scanning were performed to measure the peak systolic velocity(PSV)and RI of the anterior and middle cerebral arteries.Meanwhile,20 neuromotor examinations and developmental screening tests were carried out in all the cases.Results Among the infants aged 0-3 months,compared with the control group,anterior cerebral artery PSV decreased but anterior cerebral artery RI and middle cerebral artery PSV and RI increased in the study group(P<0.05).Among the infants aged>3-6 months,compared with the control group,both anterior and middle cerebral artery PSV and RI decreased in the study group(P<0.05).The abnormal rates of neuromotor test results among infants aged 0-3 months and infants aged>3-6 months in the study group(69%and 67%,respectively)were respectively higher than those in the control group(46%and 24%,respectively)(P<0.05).In addition,the abnormal rate of developmental screening results among infants aged>3-6 months in the study group(78%)was higher than that in the control group(30%)(P<0.05).Conclusion There is a correlation between anterior cerebral artery PSV and neurodevelopmental monitoring results in high-risk infants aged 0-3 months.Both PSV and RI of anterior and middle cerebral arteries are of reference significance in neurological monitoring in high-risk infants aged>3-6 months.