高危晚期早产儿脑病患儿危险因素及其影像学变化研究  

A study on the risk factors and imaging changes of encephalopathy in high-risk late preterm infants

作　　者：王霞 冯明华[1] 黄伟棠 杨春晖[1] 赖春华[1] WANG Xia;FENG Ming-hua;HUANG Wei-tang(Zhongshan Boai Hospital,Zhongshan 528403,China)

机构地区：[1]中山市博爱医院,528403

出　　处：《中国现代药物应用》2020年第9期13-15,共3页Chinese Journal of Modern Drug Application

基　　金：早产儿脑病相关原因分析(项目编号:2017B1085)。

摘　　要：目的分析高危晚期早产儿(LPI)脑病患儿的危险因素,总结高危LPI脑病患儿的影像学变化特征。方法对148例有脑损伤高危风险的住院LPI患儿进行核磁共振成像(MRI)检查,回顾性分析其产前产时病史、新生儿期疾病、机械通气、MRI等临床资料。分析早产儿脑病(EOP)的MRI影像表现、影响高危LPI患儿EOP的危险因素以及EOP检出率与胎龄、出生体重的关系。结果高危LPI脑病发病与胎龄无关,不同胎龄高危LPI病例的EOP检出率比较,差异无统计学意义(P>0.05);高危LPI脑病发病与出生体重相关,出生体重越低EOP的检出率越高,不同出生体重高危LPI病例的EOP检出率比较,差异具有统计学意义(P<0.05)。单因素分析显示,复苏史和5 min Apgar评分≤5分是高危LPI脑病的危险因素(P<0.05)。Logistic回归分析发现,复苏史是高危LPI脑病的独立危险因素[RR=2.481,95%CI=(1.807, 3.413)]。结论脑白质损伤是常见的高危LPI脑病,复苏史是其独立危险因素,对患儿预后影响深远,需慎重对待。Objective To analyze the risk factors of encephalopathy in high-risk late preterm infants(LPI), and summarize the imaging characteristics of encephalopathy in LPI. Methods Magnetic resonance imaging(MRI) examinations were performed on 148 hospitalized LPI at high risk of brain injury, and their clinical data including prenatal and antenatal history, neonatal disease, mechanical ventilation, and MRI were retrospectively analyzed. The MRI manifestations of encephalopathy of prematurity(EOP), the risk factors of EOP in high risk LPI, and the correlation between the detection rate of EOP and gestational age and birth weight were analyzed. Results The incidence of high-risk LPI encephalopathy had nothing to do with gestational age. There was no statistically significant difference in the detection rate of EOP in high risk LPI cases of different gestational ages(P>0.05). The incidence of high-risk LPI encephalopathy is related to birth weight. The lower the birth weight, the higher the detection rate of EOP. There was statistically significant difference in the detection rate of EOP in high risk LPI cases of different birth weight(P<0.05). Univariate analysis showed that resuscitation history and 5 min Apgar score ≤ 5 points were the risk factors of high risk LPI encephalopathy(P<0.05). Logistic regression analysis showed that the resuscitation history was an independent risk factor for high-risk LPI encephalopathy [RR=2.481, 95%CI=(1.807, 3.413)]. Conclusion White matter injury is a common high-risk LPI encephalopathy, and resuscitation history is an independent risk factor, which has a far-reaching impact on the prognosis of children, so it should be treated seriously.

关 键 词：晚期早产儿 早产儿脑病 核磁共振成像检查 危险因素 

分 类 号：R748[医药卫生—神经病学与精神病学]