早产与足月HIE的临床危险因素及颅脑MRI对比研究  

Comparative Study of Clinical Risk Factors and Brain MRI Between Preterm and Full-Term HIE

作　　者：何青 江林 苏端 马学进 王娟 段淼 刘衡 李仕广 HE Qing;JIANG Ling;SU Duan;MA Xue-jin;WANG Juan;DUAN Miao;LIU Heng;LI Shiguang(Department of Radiology,the Second People's Hospital of Guiyang,Guiyang 550081,Guizhou Province,China;Department of Radiology,the Third Affiliated Hospital of Zunyi Medical University,Zunyi 563000,Guizhou Province,China;Department of Neonatology,the Third Affiliated Hospital of Zunyi Medical University,Zunyi 563000,Guizhou Province,China;Department of Radiology,the First Affiliated Hospital of Zunyi Medical University,Zunyi 563000,Guizhou Province,China)

机构地区：[1]贵阳市第二人民医院放射科,贵州贵阳550081 [2]遵义医科大学第三附属医院放射科,贵州遵义563000 [3]遵义医科大学第三附属医院新生儿科,贵州遵义563000 [4]遵义医科大学第一附属医院放射科,贵州遵义563000

出　　处：《中国CT和MRI杂志》2023年第6期1-3,共3页Chinese Journal of CT and MRI

基　　金：遵义市科学技术局遵义市第一人民医院防控新型冠状病毒技术攻关及集成应用项目(遵市科合HZ号(2020)1号)。

摘　　要：目的对比分析早产与足月新生儿缺氧缺血性脑病(HIE)的临床危险因素及颅脑MRI表现。方法共纳入我院2016年1月至2020年12月分娩的148例HIE新生儿(包括114例早产儿和34例足月儿)。回顾性分析其临床危险因素和MRI表现的特点,所有婴儿均接受常规MRI和DWI扫描。结果(1)临床高危因素:足月组瘢痕子宫(P=0.042)和羊水污染(P=0.004)发生率较早产组显著增加(P<0.05)。两者在孕期高血压(P=0.854)、剖宫产(P=0.161)、孕期贫血(P=0.308)、孕龄(P=0.590)、前置胎盘(P=0.077)等方面无统计学差异组(P>0.05)。(2)颅脑MRI表现:足月组分水岭损伤发生率(P=0.001)较早产组明显增加(P<0.05)。早产组脑室周围白质损伤(P<0.001)和颅内出血(P=0.026)发生率较足月组明显增加(P<0.05)。两组间基底节/丘脑(P=0.430)、内囊后肢(P=0.324)和胼胝体损伤(P=1.000)差异无统计学意义。结论密切监测不同孕周胎儿发生HIE的危险因素及MRI脑损伤模式可能对HIE预防、早期诊断、干预及改善预后方面具有一定指导价值。Objective To compare the clinical risk factors and MRI findings of hypoxic-ischemic encephalopathy(HIE)between preterm and full-term newborns.Methods In total,148 cases of neonates with HIE who delivered from January 2016 to December 2020 in Our Hospital were included(including 114 premature infants and 34 full-term infants).The characteristics of clinical risk factors and MRI findings were retrospectively analyzed.All the infants underwent conventional magnetic resonance imaging and DWI imaging.Results(1)Clinical risk factors:In the term group,the incidence of scar uterus(P=0.042)and amniotic fluid pollution(P=0.004)were significantly increased compared with the preterm group(P<0.05).No statistical difference was observed in hypertension during pregnancy(P=0.854),cesarean section(P=0.161),anemia during pregnancy(P=0.308),maternal age(P=0.590)and placenta previa(P=0.077)between the two groups(P>0.05).(2)Brain MRI findings:In the term group,the rate of watershed injury(P=0.001)was significantly increased compared with the preterm group(P<0.05).In the preterm group,the rate of periventricular white matter injury(P<0.001)and intracranial hemorrhage(P=0.026)was significantly increased compared with the term group(P<0.05).No statistical difference was observed in basal ganglia/thalamus(P=0.430),posterior limb of internal capsule(P=0.324)and corpus callosum injury(P=1.000)between the two groups.Conclusion Closely monitoring the risk factors and MRI brain injury patterns of HIE in fetuses at different gestational weeks may have certain guiding value for HIE prevention,early diagnosis,intervention and improving prognosis.

关 键 词：早产儿与足月儿 新生儿缺氧缺血性脑病 围产期高危因素 磁共振成像 

分 类 号：R742[医药卫生—神经病学与精神病学] R445.2[医药卫生—临床医学]