目的探讨足月新生儿缺氧缺血性脑损伤(Hypoxic ischemic brain injury in term neonates,HIE)使用各向异性分数(Anisotropic fraction,FA)预测神经系统发育情况。方法选取2017年1月至2022年1月我院收治76例HIE患儿为观察对象,其中重度1...目的探讨足月新生儿缺氧缺血性脑损伤(Hypoxic ischemic brain injury in term neonates,HIE)使用各向异性分数(Anisotropic fraction,FA)预测神经系统发育情况。方法选取2017年1月至2022年1月我院收治76例HIE患儿为观察对象,其中重度14例、中度25例、轻度37例,另纳入30例健康足月儿为对照组;所有患儿均接受磁共振扩散张量成像(MR diffusion tensor imaging,DTI),测定小儿胼胝体压部、膝部、豆状核、内囊前肢、后肢等FA值,观察不同脑损伤程度患儿FA差异。对比预后不良好组与良好组FA值,分析其预测价值。结果HIE损伤组与对照组豆状核FA值对比,无统计学意义(P>0.05);而损伤组胼胝体压部等的FA值均低于对照组,差异有统计学意义(P<0.05)。并且患儿FA值随着脑损伤程度加重,呈现下降趋势。良好组豆状核与不良好组FA值对比,差异无统计学意义(P>0.05);良好组胼胝体压部等FA值明显高于不良好组,差异有统计学意义(P>0.05)。利用ROC曲线分析显示,豆状核FA值并不具备预测价值(P>0.05);内囊前肢FA值预测的特异性最高,其次为胼胝体膝部。结论HIE患儿使用FA检测,可对患儿脑损伤程度与预后情况定量评价,具备良好的预测价值。展开更多
Gestational age at delivery and spontaneous prematurity are independent risk factors for white matter damage (WMD). However, among infants delivered spontaneously after preterm premature rupture of membranes (PPROM), ...Gestational age at delivery and spontaneous prematurity are independent risk factors for white matter damage (WMD). However, among infants delivered spontaneously after preterm premature rupture of membranes (PPROM), latency of PPROM has been inconsistently correlated with risk of WMD. We have explored whether gestational age at membrane rupture is independently associated with WMD. Study design: Using a cohort of 196 liveborn singleton nonanomalous neonates born at 24.0 to 33.6 weeks from January 1993 to December 2002 after PPROM and who survived 7 days, we compared the characteristics of those who developed WMD (n = 15) with those who did not (n = 181) using Fisher exact test, Student t test, and logistic regression analysis, with a 2- tailed P < .05 or odds ratio (OR) with 95% CI not inclusive of the unity considered significant. Results: Stepwise logistic regression analysis demonstrated that gestational age at PPROM (P < .001, OR 0.79) was significantly associated with WMD. The association was independent of corticosteroid administration (P = .016), latency interval (P=.69), gestational age at delivery (P=.99), and birth weight (P = .62). Conclusion: Among premature infants born at < 34 weeks after PPROM, gestational age at diagnosis is independently associated with WMD.展开更多
文摘Gestational age at delivery and spontaneous prematurity are independent risk factors for white matter damage (WMD). However, among infants delivered spontaneously after preterm premature rupture of membranes (PPROM), latency of PPROM has been inconsistently correlated with risk of WMD. We have explored whether gestational age at membrane rupture is independently associated with WMD. Study design: Using a cohort of 196 liveborn singleton nonanomalous neonates born at 24.0 to 33.6 weeks from January 1993 to December 2002 after PPROM and who survived 7 days, we compared the characteristics of those who developed WMD (n = 15) with those who did not (n = 181) using Fisher exact test, Student t test, and logistic regression analysis, with a 2- tailed P < .05 or odds ratio (OR) with 95% CI not inclusive of the unity considered significant. Results: Stepwise logistic regression analysis demonstrated that gestational age at PPROM (P < .001, OR 0.79) was significantly associated with WMD. The association was independent of corticosteroid administration (P = .016), latency interval (P=.69), gestational age at delivery (P=.99), and birth weight (P = .62). Conclusion: Among premature infants born at < 34 weeks after PPROM, gestational age at diagnosis is independently associated with WMD.
