颅脑超声联合相关血清指标对羊膜腔感染综合征早产儿缺氧缺血性脑病的临床诊断价值  

The clinical value of craniocerebral ultrasound combined with blood index on hypoxic-ischemic encephalopathy of premature infants with intraamniotic infectious syndrome

作　　者：李志林[1] 裘品丹[1] 翁纽周[1] 曾丽娟[1] LI Zhilin;QIU Pindan;WENG Niuzhou;ZENG Lijuan(Department of Ultrasound Medicine, Huizhou Central Municipal Hospital, Huizhou 516001, P.R.China)

机构地区：[1]广东省惠州市中心人民医院超声医学科,广东惠州516001

出　　处：《医学影像学杂志》2022年第2期199-204,共6页Journal of Medical Imaging

基　　金：广东省惠州市科技计划项目(编号:2016Y025)。

摘　　要：目的探讨颅脑超声联合血液指标对羊膜腔感染综合征(IAIS)早产儿缺氧缺血性脑病(HIE)的临床价值。方法选取本院2017年1月~2019年1月新生儿科收治的30例IAIS早产儿,所有产妇均符合《妇产科学》中有关胎膜早破的诊断条例标准。将30例IAIS早产HIE患儿纳入AC组,选取同一时期的非IAIS早产HIE患儿30例纳入NAU组;AC、NAU组分别采取超声和MRI的诊断方式,并将AC组结果纳入ACB和ACI,NAU组结果纳入NAUB和NAUI组;在3 h、3天和12天时间节点,对比ACB、NAUB组的超声分度和血清学指标,及ACB、ACI、NAUB和NAUI的Vd、Vs、RI值。对ACB、NAUB组中存在显著差异的指标进行ROC曲线分析,判断各指标的特异性、灵敏性。结果在3 h、3天和12天时间节点,ACB与NAUB组的I~III度P均>0.05,差异无统计学意义,而在3 h节点,ACB与ACI的Vd、Vs、RI差异均有统计学意义(P均<0.05),而ACB与NAUB之间,NAUB与NAUI之间P均>0.05,差异无统计学意义;3天和12天的ACB与ACI、NAUB、NAUI之间P均>0.05,差异无统计学意义。Vs、Vd、RI、NSE和AMD的诊断敏感性为93.33%;特异性为96.76%。结论超声联合Vd、Vs、RI、ADM和NSE等血液指标,对于IAIS早产患儿的HIE诊断具有较好的特异性和敏感性,可以提高早期超声诊断的准确率。Objective To explore the clinical value of craniocerebral ultrasound combined with blood index in the treatment of hypoxic-ischemic encephalopathy of premature infants with amniotic cavity infection syndrome.Methods 30 IAIS premature infants admitted to our hospital from January 2017 to January 2019 were selected.All the pregnant women met the diagnostic criteria of premature rupture of membranes in obstetrics and gynecology.30 cases of premature HIE with IAIS were included in AC group,and 30 cases of non IAIS preterm HIE in the same period were selected as NAU group.Ultrasound and MRI were used in AC and NAU groups respectively,and the results of AC group were included in ACB and ACI,and the results of NAU group were included in NAUB and NAUI groups.At the time points of 3 h,3 d and 12 d,the ultrasonic grading and serological indexes of ACB and NAUB groups,and the Vd,Vs and RI value of ACB,ACI,NAUB and NAUI were compared.ROC curve analysis was used to determine the specificity and sensitivity of each index.Results At 3 h,3 d and 12 d time points,there was no significant difference in degree I~III between ACB and NAUB group(all P>0.05).The difference was not statistically significant,but there were significant differences in Vd,Vs,RI between ACB and ACI(all P<0.05).The difference was not statistically significant,but there was no significant difference between ACB and NAUB,between NAUB and NAUI(P>0.05);there was not significont different between between ACB and ACI,NAUB and NAUI at 3 d and 12 d(all P>0.05).The difference was not statistically significant.The sensitivity of Vs,Vd,RI,NSE and AMD was 93.33%,and the specificity was 96.76%.Conclusion The indexes of Vd,Vs,RI,ADM and NSE had better specificity and sensitivity for the diagnosis HIE premature infants of IAIS.

关 键 词：缺氧缺血性脑病 羊膜腔感染综合征 超声诊断 

分 类 号：R722.6[医药卫生—儿科] R445.1[医药卫生—临床医学]