颅脑超声检查联合血清D二聚体、乳酸脱氢酶在不同胎龄早产儿颅脑损伤诊断中的应用  

The application of brain ultrasound combined with serum D-dimer and lactate dehydrogenase in the diagnosis of brain injury in premature infants of different gestational ages

作　　者：史晶 于宁[1] SHI Jing;YU Ning(Department of Ultrasound,Affiliated Hospital of Qingdao University,Qingdao 266000,China;Department of Ultrasound,Chengwu County People's Hospital,Heze 274200,China)

机构地区：[1]青岛大学附属医院腹部超声科,山东青岛266000 [2]山东省成武县人民医院超声科,山东菏泽274200

出　　处：《医学影像学杂志》2022年第12期2054-2057,共4页Journal of Medical Imaging

摘　　要：目的探讨颅脑超声检查+血清D二聚体(D-D)+乳酸脱氢酶(LDH)诊断不同胎龄早产儿颅脑损伤的价值。方法选取早产儿140例,按不同胎龄进行分组,将其中40例<28周作为A组,45例28~32周作为B组,55例33~36周作为C组,另选择同期正常新生儿30例作为D组,各组均开展颅脑超声检查,并测定其血清D-D、LDH,对比不同胎龄早产儿的颅脑损伤发生率、舒张末期血流速度(EDV)、收缩期峰值流速(PSV)、血管阻力指数(RI)、D-D、LDH,最后对比颅脑超声检查、D-D、LDH三者联合与单一检查中颅脑损伤的检出率,比较各组的检查结果。结果140例中检出61例颅脑损伤,检出率43.57%(61/140),其中A组颅脑损伤发生率高于B、C组(P<0.05)。A组EDV、PSV、RI均低于B、C、D组(P<0.05)。A组D-D、LDH均高于B、C、D组(P<0.05)。三者联合的检出率高于单一检查(P<0.05)。结论颅脑超声检查+血清D-D+LDH的诊断价值更高,能够准确检出不同胎龄早产儿的颅脑损伤类型,其中年龄越小者颅脑损伤的发生率越高,应受到临床重点关注。Objective To study the value of brain ultrasound+serum D-dimer(D-D)+lactate dehydrogenase(LDH)in the diagnosis of brain injury in premature infants of different gestational ages.Methods 140 premature infants admitted to our hospital from July 2020 to May 2022 were selected by retrospective analysis.They were grouped according to different gestational ages.Among them,40 infants<28 weeks were treated as group A,45 infants<28 weeks as group B,55 infants<33 to 36 weeks as group C,and 30 normal newborns at the same period were treated as group D.Brain ultrasound was performed in each group,and their serum D-D and LDH were measured.We compared the incidence of brain injury end diastolic blood flow velocity(EDV),peak systolic velocity(PSV),vascular resistance index(RI),D-D,LDH,and finally compared the detection rate of brain injury in the combined and single examinations of brain ultrasound,D-D,LDH,and finally compared the examination results of each group.Results In this trial,there were 140 premature infants,61 of whom were detected,with a detection rate of 43.57%(61/140).The incidence of brain injury in group A was higher than that in groups B and C(P<0.05).EDV,PSV and RI in group A were lower than those in group B,C and D(P<0.05).D-D and LDH in group A were higher than those in group B,C and D(P<0.05).The detection rate of combination of three methods was higher than that of single method(P<0.05).Conclusion The diagnostic value of brain ultrasound+serum D-D+LDH is higher,which can accurately detect the type of brain injury in premature infants of different gestational ages.The younger the age is,the higher the incidence of brain injury is.It should be paid attention clinically and diagnosed as early as possible to provide reference for the formulation of follow-up treatment plans.

关 键 词：颅脑损伤 超声检查 D二聚体 乳酸脱氢酶 早产儿 

分 类 号：R445.1[医药卫生—影像医学与核医学] R714.5[医药卫生—诊断学]