颅脑超声预测高危新生儿神经发育情况的临床价值  

Clinical value of cranial ultrasound in predicting neurodevelopmental outcomes in high-risk neonates

作　　者：方洁莹 邱懿德[2] 王平 FANG Jieying;QIU Yide;WANG Ping(Department of Ultrasound Medicine,the Third Affiliated Hospital of Southern Medical University,Guangzhou 510630,China;Ultrasound Treatment Center,Foshan First People’s Hospital,Foshan 528000,China)

机构地区：[1]南方医科大学第三附属医院超声医学科,广东广州510630 [2]佛山市第一人民医院超声诊疗中心,广东佛山528000

出　　处：《临床超声医学杂志》2025年第3期210-214,共5页Journal of Clinical Ultrasound in Medicine

摘　　要：目的应用颅脑超声检测高危新生儿脑血流动力学变化,探讨其预测神经发育情况的临床应用价值。方法选取我院新生儿重症监护室收治的高危新生儿102例,根据随访6个月新生儿神经发育情况分为异常组45例和正常组57例,应用颅脑超声获取其大脑中动脉水平段脑血流动力学参数,包括收缩期峰值流速(PSV)、舒张末期流速(EDV)、阻力指数(RI)、搏动指数(PI),比较两组脑血流动力学参数的差异。采用Logistic回归分析筛选预测新生儿神经发育异常的独立影响因素;绘制受试者工作特征(ROC)曲线分析各参数单独及联合应用预测新生儿神经发育异常的诊断效能。结果异常组新生儿RI、PI均高于正常组,PSV、EDV均低于正常组,差异均有统计学意义(均P<0.05)。Logistic回归分析显示,RI、PI均为预测新生儿神经发育异常的独立危险因素,PSV、EDV均为独立保护因素(均P<0.05)。ROC曲线分析显示,PSV、EDV、RI、PI预测高危新生儿神经发育异常的曲线下面积分别为0.861、0.868、0.818、0.872,各参数联合应用的曲线下面积为0.978,高于其单独应用,差异均有统计学意义(Z=3.751、4.133、3.052、3.421,均P<0.05)。结论颅脑超声在预测高危新生儿神经发育情况中具有一定的临床应用价值。Objective To measure the cerebral hemodynamic changes in high-risk neonates by cranial ultrasound,and to explore its clinical value in predicting neurodevelopmental outcomes.Methods A total of 102 high-risk neonates admitted to the neonatal intensive care unit in our hospital were enrolled,according to the neurodevelopmental outcomes at 6 months of follow-up,the neonates were divided into abnormal group(45 cases)and normal group(57 cases).Cranial ultrasound was used to measure cerebral hemodynamic parameters of middle cerebral artery horizontal segment,including peak systolic velocity(PSV),end-diastolic velocity(EDV),resistance index(RI),and pulsatility index(PI).The differences in cerebral hemodynamic parameters between the two groups were compared.Logistic regression analysis was performed to identify independent influencing factors for predicting neurodevelopmental abnormalities.Receiver operating characteristic(ROC)curve was drawn to analyze the diagnostic performance of individual and combined cerebral hemodynamic parameters in predicting neurodevelopmental abnormalities.Results The RI and PI in the abnormal group were significantly higher than those in the normal group,while PSV and EDV were significantly lower(all P<0.05).Logistic regression analysis showed that RI and PI were independent risk factors for predicting neurodevelopmental abnormalities,while PSV and EDV were independent protective factors(all P<0.05).ROC curve analysis showed that the area under the curve(AUC)of PSV,EDV,RI,and PI in predicting neurodevelopmental abnormalities were 0.861,0.868,0.818,and 0.872,respectively.The AUC of combined parameters was 0.978,which was significantly higher than that of each parameter alone(Z=3.751,4.133,3.052,3.421,all P<0.05).Conclusion Cranial ultrasound has a certain clinical application value in predicting neurodevelopmental outcomes in high-risk neonates.

关 键 词：超声检查 颅脑 脑血流动力学 脑神经发育 高危新生儿 

分 类 号：R445.1[医药卫生—影像医学与核医学]