实用临床医学
實用臨床醫學
실용림상의학
Practical Clinical Medicine
2014年
4期
76-79
,共4页
李先红%张健%郑洪%孔萤%孙路璐%刘光辉
李先紅%張健%鄭洪%孔螢%孫路璐%劉光輝
리선홍%장건%정홍%공형%손로로%류광휘
胆红素脑病%脑脊液%血清%总胆红素%磁共振成像%婴儿,新生
膽紅素腦病%腦脊液%血清%總膽紅素%磁共振成像%嬰兒,新生
담홍소뇌병%뇌척액%혈청%총담홍소%자공진성상%영인,신생
bilirubin encephalopathy%cerebrospinal fluid%serum%total bilirubin%magnetic resonance imaging%infant,newborn
目的：探讨新生儿胆红素脑病脑脊液总胆红素水平的变化及颅脑MRI特征改变的临床意义。方法使用全自动生化分析仪、采用钒酸盐氧化法检测44例胆红素脑病组和79例非胆红素脑病组血清总胆红素水平及脑脊液总胆红素水平，并对2组行颅脑MRI检查。结果胆红素脑病组脑脊液、血清总胆红素水平均显著高于非胆红素脑病组（均P＜0.01）。胆红素脑病组MRI表现为T1WI苍白球对称性高信号33例，其他部位高信号7例（MRI 表现为1例右侧基底节区内囊后肢外侧小片状异常信号、1例右侧尾状核头T1WI高信号、3例侧脑室旁异常信号、1例双侧额叶异常信号和1例窦汇处短T1T2信号），MRI未见异常信号4例。非胆红素脑病组MRI表现为T1WI苍白球对称性高信号3例，其他部位高信号1例（MRI 表现为1例右侧顶枕部点状异常信号），MRI未见异常信号75例。胆红素脑病组MRI T1WI苍白球对称性高信号发生率明显高于非胆红素脑病组（P＜0.01）。结论脑脊液总胆红素水平检测可作为胆红素脑病早期诊断的可靠指标，胆红素脑病新生儿早期颅脑MRI主要特征为T1WI苍白球对称性高信号，需定期随访并早期干预治疗。
目的：探討新生兒膽紅素腦病腦脊液總膽紅素水平的變化及顱腦MRI特徵改變的臨床意義。方法使用全自動生化分析儀、採用釩痠鹽氧化法檢測44例膽紅素腦病組和79例非膽紅素腦病組血清總膽紅素水平及腦脊液總膽紅素水平，併對2組行顱腦MRI檢查。結果膽紅素腦病組腦脊液、血清總膽紅素水平均顯著高于非膽紅素腦病組（均P＜0.01）。膽紅素腦病組MRI錶現為T1WI蒼白毬對稱性高信號33例，其他部位高信號7例（MRI 錶現為1例右側基底節區內囊後肢外側小片狀異常信號、1例右側尾狀覈頭T1WI高信號、3例側腦室徬異常信號、1例雙側額葉異常信號和1例竇彙處短T1T2信號），MRI未見異常信號4例。非膽紅素腦病組MRI錶現為T1WI蒼白毬對稱性高信號3例，其他部位高信號1例（MRI 錶現為1例右側頂枕部點狀異常信號），MRI未見異常信號75例。膽紅素腦病組MRI T1WI蒼白毬對稱性高信號髮生率明顯高于非膽紅素腦病組（P＜0.01）。結論腦脊液總膽紅素水平檢測可作為膽紅素腦病早期診斷的可靠指標，膽紅素腦病新生兒早期顱腦MRI主要特徵為T1WI蒼白毬對稱性高信號，需定期隨訪併早期榦預治療。
목적：탐토신생인담홍소뇌병뇌척액총담홍소수평적변화급로뇌MRI특정개변적림상의의。방법사용전자동생화분석의、채용범산염양화법검측44례담홍소뇌병조화79례비담홍소뇌병조혈청총담홍소수평급뇌척액총담홍소수평，병대2조행로뇌MRI검사。결과담홍소뇌병조뇌척액、혈청총담홍소수평균현저고우비담홍소뇌병조（균P＜0.01）。담홍소뇌병조MRI표현위T1WI창백구대칭성고신호33례，기타부위고신호7례（MRI 표현위1례우측기저절구내낭후지외측소편상이상신호、1례우측미상핵두T1WI고신호、3례측뇌실방이상신호、1례쌍측액협이상신호화1례두회처단T1T2신호），MRI미견이상신호4례。비담홍소뇌병조MRI표현위T1WI창백구대칭성고신호3례，기타부위고신호1례（MRI 표현위1례우측정침부점상이상신호），MRI미견이상신호75례。담홍소뇌병조MRI T1WI창백구대칭성고신호발생솔명현고우비담홍소뇌병조（P＜0.01）。결론뇌척액총담홍소수평검측가작위담홍소뇌병조기진단적가고지표，담홍소뇌병신생인조기로뇌MRI주요특정위T1WI창백구대칭성고신호，수정기수방병조기간예치료。
Objective To explore the clinical significance of changes in cerebrospinal fluid bilirubin levels and craniocerebral magnetic resonance imaging (MRI)features in newborns with bilir-ubin encephalopathy. Methods Total bilirubin levels in serum and cerebrospinal fluid were determined using vanadate oxidation method with automatic biochemical analyzer in 44 newborns with bilirubin encephalopathy (bilirubin encephalopathy group)and 79 newborns without bilirubin enceph-alopathy (non-bilirubin encephalopathy group).In addition,craniocerebral MRI was performed in both groups. Results Total bilirubin levels in serum and cerebrospinal fluid in bilirubin encephalopathy group were significantly higher than those in non-bilirubin encephalopathy group (P<0.01).In bilirubin enceph-alopathy group,MRI showed symmetrical high signal intensity in the globus pallidus on T1WI in 33 newborns,abnormal signal in lateral side of posterior limb of internal capsule in the right basal ganglion region in 1 newborn,high signal intensity in the head of the right caudate nucleus on T1WI in 1 newborn, abnormal signal in the lateral ventricle in 3 newborns,abnormal signal in the bilateral frontal lobes in 1 newborn, short T1T2 signal in the torcular herophili in 1 newborn,and normal signal in 4 newborns. In non-bilirubin encephalopathy group,MRI showed symmetrical high signal intensity in the globus pallidus on T1WI in 3 newborns, abnormal signal in the right side of top occipital in 1 newborn, and normal signal in 75 newborns. The incidence of symmetrical high T1WI signal intensity in the globus pallidus in bilirubin encephalopathy group was significantly higher than that in non-bilirubin encephalopathy group (P<0.01).Conclusion Cerebrospinal fluid bilirubin can be used as a reliable indicator for the early diagnosis of bilirubin encephalopathy. The symmetrical high signal intensity in the globus pallidus on T1WI is the main feature of bilirubin encephalopathy in newborns. Regular fol-low-up and early intervention treatment should be performed in newborns with bilirubin enceph-alopathy.
