超声动态监测早产儿颅脑损伤价值及对病情转归预测作用探究  

The value of ultrasound dynamic monitoring of craniocerebral injury in premature infants and its predictive effect on disease outcome

作　　者：刘淑燕 吴冬倩 张九菊 LIU ShuYan;WU Dongqian;ZHANG Jiuju(Department of Neonatology,Hengshui People's Hospital,Hengshui,Hebei 053000,China;The Second Department of Ultrasound,Hengshui People's Hospital,Hengshui,Hebei 053000,China)

机构地区：[1]衡水市人民医院新生儿科,河北衡水053000 [2]衡水市人民医院超声二科,河北衡水053000

出　　处：《中国优生与遗传杂志》2022年第12期2220-2224,共5页Chinese Journal of Birth Health & Heredity

基　　金：2019年河北省医学科学研究课题计划(20191779)。

摘　　要：目的 探讨超声动态监测早产儿颅脑损伤价值及对病情转归预测作用。方法 按照1∶1原则选取2020年1月至2022年1月74例早产儿颅脑损伤患儿(损伤组)、74例无颅脑损伤者(对照组),比较两组大脑中动脉的收缩期峰值流速(PSV)、舒张末期血流速度(EDV)、血管阻力指数(RI),损伤组根据病情转归情况分为不良组(n=30)、良好组(n=44),比较两组出生后、1 w后、纠正胎龄40 w时PSV、EDV、RI,Pearson分析各时间点PSV、EDV、RI与MDI评分、PDI评分关系,采用受试者操作特征(ROC)曲线分析PSV、EDV、RI预测不良病情转归价值。结果 损伤组PSV、EDV低于对照组,RI高于损伤组(P<0.05);不良组出生后、1 w后、纠正胎龄40 w时,PSV、EDV低于良好组,RI高于良好组(P<0.05),PSV、EDV与MDI评分、PDI评分呈正相关,RI与MDI评分、PDI评分呈负相关(P<0.05);PSV、EDV联合RI预测不良病情转归的AUC最大。结论 超声动态监测对早产儿颅脑损伤具有较好评估作用,PSV、EDV、RI联合检测可预测患儿病情转归,对评估患儿预后具有临床价值。Objective To investigate the value of ultrasound dynamic monitoring of craniocerebral injury in premature infants and its predictive effect on disease outcome. Methods According to the 1∶1 principle, 74 cases of premature infants with craniocerebral injury(injury group) and 74 cases without craniocerebral injury(control group) from January 2020 to January 2022 were selected. The peak systolic velocity(PSV), end-diastolic velocity(EDV), and vascular resistance index(RI) of the middle cerebral artery between the two groups were compared. The injury group was divided into a poor group(n=30) and a good group according to the prognosis(n=44). The PSV, EDV, and RI were compared between the two groups after birth, 1 week later, and corrected gestational age at 40 weeks. Pearson analyzed the relationship between PSV, EDV, RI and MDI score and PDI score at each time point. The receiver operating characteristic(ROC) curve was used to analyze the relationship between the two groups. The value of PSV, EDV and RI in predicting adverse disease outcome. Results The PSV and EDV in the injury group were lower than those in the control group, and the RI was higher than that in the injury group(P<0.05). After birth, 1 week after birth, and corrected gestational age at 40 weeks, the PSV and EDV in the poor group were lower than those in the good group, and the RI was higher than that in the good group(P<0.05). PSV and EDV were positively correlated with MDI score and PDI score, while RI was negatively correlated with MDI score and PDI score(P<0.05). PSV,EDV combined with RI had the largest AUC in predicting adverse disease outcomes. Conclusion Ultrasound dynamic monitoring has a good effect on evaluating the craniocerebral injury in premature infants. The combined detection of PSV, EDV and RI can predict the prognosis of children, and has clinical value in evaluating the prognosis of children.

关 键 词：超声 早产儿 脑损伤 病情转归 

分 类 号：R445.1[医药卫生—影像医学与核医学] R722.6[医药卫生—诊断学]