CAJ | 학술논문

目的：分析妊娠期高血压疾病孕妇分娩的新生儿颅脑超声图像特征，探讨妊娠期高血压疾病对新生儿脑损伤及脑发育的影响。方法对2013年10月至2014年8月哈尔滨医科大学附属第一医院新生儿重症监护室收治的妊娠期高血压疾病孕妇分娩的106例新生儿（研究组）和200例无高危围产因素孕妇分娩的新生儿（对照组）进行颅脑超声观察，比较两组新生儿颅脑超声异常表现，分析新生儿颅脑超声异常表现构成分布及颅脑超声异常表现与孕妇妊娠期高血压疾病程度的相关性。结果新生儿颅脑超声异常检出结果：（1）研究组106例，超声检出新生儿颅脑异常78例（73.6%，78/106），其中早产儿单发异常41例，包括脑室旁白质病损伤25例，脑室周围-脑室内出血14例，脑发育迟缓2例；合并异常15例；足月儿单发异常17例，包括脑室周围-脑室内出血12例，缺氧缺血性脑病3例，脑发育迟缓2例；合并异常5例。（2）对照组200例，超声检出新生儿颅脑异常73例（36.5%，73/200），其中早产儿单发异常30例，包括脑室旁白质损伤24例，脑室周围-脑室内出血4例，脑发育迟缓2例；合并异常15例；足月儿单发异常24例，包括脑室周围-脑室内出血10例，缺氧缺血性脑病14例；合并异常6例。（3）两组新生儿颅脑超声异常检出率比较差异有统计学意义（χ2=38.119，P＜0.001），但两组新生儿颅脑超声异常构成分布比较差异无统计学意义（χ2=0.552，P=0.759）。（4）孕妇妊娠期高血压疾病程度与新生儿颅脑超声异常表现的相关性差异有统计学意义（P＜0.001）。结论颅脑超声是新生儿脑异常首选和动态监测的方法，可为妊娠期高血压疾病孕妇分娩新生儿临床早期诊治及干预提供依据。
목적：분석임신기고혈압질병잉부분면적신생인로뇌초성도상특정，탐토임신기고혈압질병대신생인뇌손상급뇌발육적영향。방법대2013년10월지2014년8월합이빈의과대학부속제일의원신생인중증감호실수치적임신기고혈압질병잉부분면적106례신생인（연구조）화200례무고위위산인소잉부분면적신생인（대조조）진행로뇌초성관찰，비교량조신생인로뇌초성이상표현，분석신생인로뇌초성이상표현구성분포급로뇌초성이상표현여잉부임신기고혈압질병정도적상관성。결과신생인로뇌초성이상검출결과：（1）연구조106례，초성검출신생인로뇌이상78례（73.6%，78/106），기중조산인단발이상41례，포괄뇌실방백질병손상25례，뇌실주위-뇌실내출혈14례，뇌발육지완2례；합병이상15례；족월인단발이상17례，포괄뇌실주위-뇌실내출혈12례，결양결혈성뇌병3례，뇌발육지완2례；합병이상5례。（2）대조조200례，초성검출신생인로뇌이상73례（36.5%，73/200），기중조산인단발이상30례，포괄뇌실방백질손상24례，뇌실주위-뇌실내출혈4례，뇌발육지완2례；합병이상15례；족월인단발이상24례，포괄뇌실주위-뇌실내출혈10례，결양결혈성뇌병14례；합병이상6례。（3）량조신생인로뇌초성이상검출솔비교차이유통계학의의（χ2=38.119，P＜0.001），단량조신생인로뇌초성이상구성분포비교차이무통계학의의（χ2=0.552，P=0.759）。（4）잉부임신기고혈압질병정도여신생인로뇌초성이상표현적상관성차이유통계학의의（P＜0.001）。결론로뇌초성시신생인뇌이상수선화동태감측적방법，가위임신기고혈압질병잉부분면신생인림상조기진치급간예제공의거。
ObjectiveTo analyze the craniocerebrum ultrasonographic images of the infants born by women with hypertension in pregnancy and investigate the effect of hypertension in pregnancy on neonate brain injury and brain development.MethodsTo assess the brain injury and brain development, 106 infants born by women with hypertension in pregnancy (study group) and 200 infants born by women without high risk factors during perinatal period (control group) in the neonatal intensive care unit of First Affiliated Hospital of Harbin Medical University between 2013 and 2014 underwent brain ultrasonography. The abnormal ultrasound images and the constitution of abnormal ultrasound images distribution in two groups were compared. The relationship between the abnormal ultrasound images and the degree of hypertension in pregnancy were analyzed.ResultsThe brain ultrasonographic result of the infants : (1) In the group with hypertension in pregnancy, the abnormal ultrasound images were found in 78 cases (73.6%). For the preterm infants, the solitary abnormality was found in 41 cases (25 cases of cerebral white matter injury, 14 cases of peri-intraventricular hemorrhage and 2 case of brain hypoevolutism) and multiple abnormalities were found in 15 cases; for the full-term infants, the solitary abnormality was found in 17 cases (12 cases of peri-intraventricular hemorrhage, 3 cases of hypoxic-ischemic encephalopathy and 2 case of brain hypoevolutism) and multiple abnormalities were found in 5 cases. (2) In the group without high risk factors, abnormalities were found in 73 cases (36.5 %). For the preterm infants, abnormal ultrasound images were found in 45 cases, including solitary abnormality found in 30 cases (24 cases of cerebral white matter injury, 4 cases of peri-intraventricular hemorrhage and 2 case of brain hypoevolutism) and multiple abnormalities found in 15 cases; for the full-term infants, the abnormal ultrasound images were found in 30 cases, including solitary abnormality found in 24 cases (10 cases of peri-intraventricular hemorrhage and 14 cases of hypoxic-ischemic encephalopathy) and multiple abnormalities found in 6 cases. (3) There were obvious statistical significances between the comparativeness of two groups (χ2=38.119,P<0.001), but there were no statistical significances in the constitution of the abnormal ultrasound images distribution between the two groups (χ2=0.552,P=0.759). (4) There were statistical significances between the comparativeness of the abnormal ultrasound images and the degree of hypertensive disorder complicating pregnancy (P<0.001). ConclusionCraniocerebrum ultrasonography is the first choice to detect and monitor brain abnormal and can provide basis for clinical diagnosis, treatment and intervention at early stage for the infants born by women with hypertension in pregnancy.