新生儿缺氧缺血性脑病rCBF显像分级诊断与预后研究

CLINICAL EVALUTION OF ^( 99) TC^m-ECD SPECT REGIONAL CEREBAL BLOOD FLOW IMAGING IN CLASSIFYING DIAGNOSIS OF NEONATAL HYPOXIC-ISCHEMIC ENCEPHALOPATHY AND PROGNOSIS

目的 :通过预后探讨局部脑血流 (rCBF)断层显像分级诊断新生儿缺氧缺血性脑病 (HIE)的临床价值。方法 :对 32例HIE患儿行rCBF显像 ,根据放射性分布情况将显像结果分为 0、Ⅰ、Ⅱ、Ⅲ级 ;随访全部对照 3～ 6年 ,正常记 0分 ,有癫痫表现记 1分 ,智力低下记 2分 ,脑瘫记 3分 ;将各级得分进行比较。结果 :HIE并发症发生率为 2 5 % (8/ 32 ) ,Ⅲ级平均得分 (0 .5分 )明显高于 0 (0分 )、Ⅰ (0 .0 7分 )、Ⅱ (0 .5分 )级 (t=5 .89、10 .82、4 .2 7,P <0 .0 1) ,Ⅰ、Ⅱ级间差异有显著性 (t =2 .79,P <0 .0 5 )。结论 :rCBF显像能客观反映HIE的严重程度 ,有较高的预后预测价值 ,可作为临床分度诊断的标准之一。

Objective:To assess the clinical value of 99 TC m-ECD SPECT regional cerebal blood flow (rCBF) imaging in classifying diagnosis of neonatal hypoxic-ischemic encephalopathy (HIE) by sudying prognosis.Methods:The rCBF imaging was performed on 32 patients with HIE. O, Ⅰ,Ⅱ, and Ⅲ groups were classified according to their radionuclide distribution. All objects were followed-up 3～6 years. Normal objects were marked 0, those demonstated epilepsy 1, mental retardation 2, and cerebroparalysis 3.All groups markes were compared.Results:The complication rate of HIE was 25%. The average mark of Ⅲ groups(2.25) was more significantly higher than O,Ⅰ and Ⅱgroup( 0, 0.07, 0.5) (t =5.89, 10.82, 4.27, P <0.01). Their average marks were significant difference were between Ⅰ and Ⅱ groups( t=2.79,P <0.05).Conclusion: rCBF imaging in classifying diagnosis of HIE is more useful in evaluting the cerebral destruction, predicting the prognosis, and being suggested as one of the clinical classified diagnosic standards.