新生儿高胆红素血症所致脑损伤患儿的早期监测研究现状  

Research status of early monitoring of brain injury caused by neonatal hyperbilirubinemia

作　　者：王淑惠 薛梅[2] Wang Shuhui;Xue Mei(Graduate School of Dalian Medical University,Dalian 116000,Liaoning Province,China;Department of Neonate,Jiangsu Taizhou People′s Hospital,Taizhou 225300,Jiangsu Province,China)

机构地区：[1]大连医科大学研究生院,116000 [2]江苏省泰州市人民医院新生儿科,225300

出　　处：《中华妇幼临床医学杂志（电子版）》2021年第6期634-642,共9页Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition)

基　　金：江苏省卫健委妇幼健康科研项目(F201813)。

摘　　要：新生儿高胆红素血症(NHB)所致脑损伤虽然是可以预防的,但是脑损伤仍然该病患儿的最常见并发症。部分NHB所致脑损伤患儿临床表现隐匿,症状缺乏特异性,易发生漏诊及延误治疗,从而造成患儿不可逆神经系统后遗症。目前,临床对NHB脑损伤的诊断,主要结合患儿临床表现及头颅MRI和脑干听觉诱发电位等辅助检查进行。近年提倡尽早对高危NHB所致脑损伤患儿进行脑功能监测和脑损伤生物标志物检测,包括S100B蛋白、神经特异性烯醇化酶(NSE),同时结合神经行为评分,如胆红素所致神经功能障碍(BIND)、新生儿行为神经测定(NBNA)评分。分子遗传学检测作为诊断NHB所致脑损伤患儿的新兴监测技术,其发展前景广阔。目前,磁共振弥散成像(DWI)、磁共振波谱成像(MRS)在NHB所致脑损伤患儿的临床应用价值有待研究、证实。brain injury caused by Although neonatal hyperbilirubinemia(NHB)is the most common complication of NHB.Some children with brain injury caused by NHB have hidden clinical manifestations,lack of specificity,and are prone to missed diagnosis and delayed treatment,thus resulting in irreversible neurological sequelae.Currently,the diagnosis of brain injury caused by NHB is mainly combined with clinical manifestations,brain MRI and brain stem auditory evoked potential and other auxiliary examinations.In recent years,early monitoring of brain function and detection of biochemical markers of brain injury,such as S100B protein and neuron-specific enolase(NSE)have been advocated for brain injury caused by high-risk NHB.At the same time,combined with neurobehavioral score,bilirubin-induced neurological dysfunction(BIND)score and neonatal behavioral neurological assessment(NBNA)score,children at high risk of brain injury caused by NHB have been evaluated.Molecular genetics detection,as an emerging monitoring technology for diagnosis of brain injury caused by NHB,has a broad development prospect.The clinical application value of magnetic resonancediffusion weighted imaging(DWI)and magnetic resonance spectroscopy(MRS)in brain injury caused by NHB still needs to be confirmed by researches.

关 键 词：高胆红素血症 新生儿 脑损伤 核黄疸谱系障碍 神经影像学 头颅 早期诊断 生物学标记 婴儿 新生 

分 类 号：R72[医药卫生—儿科]