CAJ | 학술논문

目的：探讨新生儿缺氧缺血性脑病(HIE)的脑血流改变及在预后评估中的应用价值。方法选择2012年1月~2014年12月河北北方学院附属第一医院产科出生的足月新生儿54例为研究对象(观察组),所有患儿均有窒息史,同时选取我院产科同期出生的30例健康新生儿为对照组,检测并比较两组新生儿出生后24、48、72、120 h大脑前动脉(ACA)、大脑中动脉MCA)、大脑后动脉(PCA)的阻力指数(RI)、舒张期流速(Vd)、收缩期峰值流速(Vs)时间以及平均流速(Vm)；观察两组新生儿脑动脉血流动力学变化情况。结果与对照组比较,观察组新生儿出生后24、48 h时ACA、MCA及PCA的Vd、Vs、Vm均明显降低(P<0.05),同时RI显著增高(P<0.05)；新生儿出生后72、120 h时上述各项指标与对照组比较,差异均无统计学意义(P>0.05)。新生儿生后24、48、72、120 h,轻、中、重度HIE患儿RI比较,差异均有统计学意义(P<0.05),且随着HIE严重程度增加,RI不断升高,差异有统计学意义(P<0.05)。结论采用彩色多普勒超声动态监测HIE患儿的脑动脉血流动力学参数,能准确地反映患儿脑部血流变化,在HIE的早期诊断、病情判断及预后评估中具有重要意义。
목적：탐토신생인결양결혈성뇌병(HIE)적뇌혈류개변급재예후평고중적응용개치。방법선택2012년1월~2014년12월하북북방학원부속제일의원산과출생적족월신생인54례위연구대상(관찰조),소유환인균유질식사,동시선취아원산과동기출생적30례건강신생인위대조조,검측병비교량조신생인출생후24、48、72、120 h대뇌전동맥(ACA)、대뇌중동맥MCA)、대뇌후동맥(PCA)적조력지수(RI)、서장기류속(Vd)、수축기봉치류속(Vs)시간이급평균류속(Vm)；관찰량조신생인뇌동맥혈류동역학변화정황。결과여대조조비교,관찰조신생인출생후24、48 h시ACA、MCA급PCA적Vd、Vs、Vm균명현강저(P<0.05),동시RI현저증고(P<0.05)；신생인출생후72、120 h시상술각항지표여대조조비교,차이균무통계학의의(P>0.05)。신생인생후24、48、72、120 h,경、중、중도HIE환인RI비교,차이균유통계학의의(P<0.05),차수착HIE엄중정도증가,RI불단승고,차이유통계학의의(P<0.05)。결론채용채색다보륵초성동태감측HIE환인적뇌동맥혈류동역학삼수,능준학지반영환인뇌부혈류변화,재HIE적조기진단、병정판단급예후평고중구유중요의의。
Objective To investigate the changes of cerebral blood flow in neonates with hypoxic ischemic en-cephalopathy (HIE) and its application value in evaluation of prognosis. Methods 54 full-term newborns who enrolled from January 2012 to December 2014 in Obstetrical Department of the First Affiliated Hospital of Hebei North Univer-sity (“our hospital”for short) were selected as the study objects (observation group), all newborns had history of asphyxi-a;and 30 health newborns born at the same time in Obstetrical Department of our hospital were selected as control group. 24, 48, 72 and 120 h after birth, the RI, Vd, Vs, Vm of ACA, MCA, PCA in two groups were detected and com-pared; and the changes of cerebral artery hemodynamics were observed. Results Compared with control group, the Vd, Vs, Vm of ACA, MCA and PCA in observation group 24, 48 h after birth were decreased (P< 0.05), and RI were in-creased (P< 0.05); differences between two group 72, 120 h after birth in the above parameters were not statistically significant (P>0.05). RI of newborns with mild, moderate, severe HIE, in different time points were significantly differ-ent (P<0.05), with the increase of the of HIE severity, RI was increased, the difference was statistically significant (P<0.05). Conclusion Cerebral artery hemodynamic parameters by using color Doppler ultrasound to dynamic monitoring neonatal hypoxic ischemic encephalopathy, can accurately reflects the changes in blood flow to brain, has important sig-nificance in early diagnosis, assessment of severity and prognosis of HIE.