早产儿代谢性骨病高危因素及诊断的研究进展  

Research advances on high-risk factors and diagnosis of metabolic bone disease in preterm infants

作　　者：郭佳林 刘江勤 花静 GUO Jialin;LIU Jiangqin;HUA Jing(Shanghai First Maternity and Infant Hospital,Tongji University School of Medicine,Shanghai 201204,China)

机构地区：[1]同济大学附属第一妇婴保健院,上海201204

出　　处：《中国妇幼健康研究》2022年第5期126-130,共5页Chinese Journal of Woman and Child Health Research

基　　金：国家自然科学基金面上资助项目(81673179);同济大学附属第一妇婴保健院2019年度院级课题。

摘　　要：得益于国内围产医学、胎儿医学的大力发展及新生儿重症监护室(NICU)综合实力的提升,早产儿的生存率不断提高,且存活孕周也逐渐变小,但其日后生活质量却存在诸多问题,代谢性骨病(MBD)就是其中常见问题之一。因此尽早认识并积极预防MBD,早诊断、早治疗,对早产儿远期生活质量的提高有着重要的意义。定量超声技术(QUS)相较于传统的X射线、CT等传统诊断方法,具有简便、快速、无创、无辐射的优势,不仅能检测骨矿密度(BMD),还可反映骨微结构及骨的弹性和强度等特性。QUS评价长骨骨折愈合的方法主要为超声轴向传播技术,根据测量波形的不同,又分为第一到达波(FAS)法和超声导波法。近年来发现超声导波技术在早产儿MBD的临床诊断中具有很大的潜力。该文对孕产期至新生儿期的早产儿MBD的高危因素、传统诊断方法及目前几种定量超声检测方法进行综述,为建立以预测-诊断为一体的早期预防和干预MBD措施提供重要线索。Thanks to the vigorous development of perinatal medicine and fetal medicine, and the improvement of the comprehensive strength of neonatal intensive care unit(NICU) level, the survival rate of preterm infants is higher, and the survival gestational age is smaller.However, there are many problems in their quality of life in the future, among which metabolic bone disease(MBD) is one of the common problems.Therefore, early recognition and positive prevention of MBD, early diagnosis and treatment are of great significance to improve the long-term quality of life of preterm infants.Compared with the traditional diagnostic methods such as X-ray and CT, quantitative ultrasound(QUS) is simple, rapid, noninvasive and radiation-free.It can not only detect bone mineral density(BMD), but also reflect bone microstructure, bone elasticity and strength.The method of QUS used to evaluate long bone fracture healing mainly is ultrasound axial transmission technique, which is divided into the first arriving signal(FAS) method and the ultrasonic guided wave method according to the different measurement waveforms.In recent years, it has been found that ultrasonic guided wave technique has great potential in clinical diagnosis of MBD in preterm infants.This paper reviewed the high-risk factors of MBD from perinatal to neonatal periods, traditional diagnostic methods and several current quantitative ultrasound detection methods, so as to provide important clues for the establishment of early prevention and intervention for MBD with prediction and diagnosis as a whole.

关 键 词：新生儿 早产儿 代谢性骨病 定量超声技术 超声导波 

分 类 号：R174[医药卫生—妇幼卫生保健]