磁共振检查联合Gesell评分对脑损伤新生儿神经发育的预后评估价值  

The Combined Value of MRI Examination and Gesell Score in Predicting the Prognosis of Neurodevelopment in Infants with Brain Injury

作　　者：余晓婵 魏祖健 麦钻珍 YU Xiaochan;WEI Zujian;MAI Zuanzhen(Department of neonatology,2.Department of critical care medicine,Xiaolan People's Hospital of ZhongShan/The Fifth People's Hospital of ZhongShan,Zhongshan 528415)

机构地区：[1]中山市小榄人民医院/中山市第五人民医院新生儿科,中山528415 [2]中山市小榄人民医院/中山市第五人民医院重症医学科,中山528415

出　　处：《湖南师范大学学报(医学版)》2024年第6期114-118,共5页Journal of Hunan Normal University(Medical Sciences)

基　　金：中山市医学科研项目“振幅整合脑电图联合神经行为测定对足月脑损伤新生儿进行早期评估及干预的效果评价”(2022A020742)

摘　　要：目的:探讨磁共振检查(magnetic resonance imaging,MRI)联合Gesell评分对脑损伤新生儿神经发育的预后评估价值。方法:收集2022年7月—2023年7月在我院出生的脑损伤新生儿93例作为研究对象。根据头颅MRI结果将93例脑损伤新生儿分为轻度组(n=21),中度组(n=47),重度组(n=25)。根据Bayley婴幼儿发展量表,分为预后良好组65例和预后不良组28例。对比不同程度脑损伤新生儿MRI参数(T_(1)值、T_(2)值、DWI值)、Gesell评分,对比不同预后脑损伤新生儿的相关临床指标,并进行Pearson相关性分析、Logistic多因素分析及ROC曲线分析。结果:重度组患儿MRI参数(T_(1)值、T_(2)值、DWI值)均显著高于中度组和轻度组,重度组患儿Gesell评分显著低于中度组和轻度组。预后良好和预后不良组患儿性别、出生体重、1 min Apgar评分、分娩方式、孕期是否贫血无统计学差异;预后良好和预后不良组5 min Apgar评分、T_(1)值、T_(2)值、DWI值、Bayley评分及Gesell评分有统计学差异。经过Pearson相关性分析,脑损伤新生儿MRI参数(T_(1)值、T_(2)值、DWI值)与智力发育指数(mental development index,MDI)、运动发育指数(psychomotor development index,PDI)均呈负相关,Gesell评分与MDI、PDI均呈正相关。Logistic多因素分析结果显示,5 min Apgar评分、T_(1)值、T_(2)值、DWI值、Gesell评分是脑损伤新生儿神经发育预后的独立影响因素。ROC曲线显示,MRI参数联合Gesell评分预测脑损伤新生儿神经发育预后的AUC、敏感度均显著高于各指标单独诊断。结论:MRI参数联合Gesell评分对脑损伤新生儿神经发育的预后具有较高的预测价值。Objective To explore the prognostic value of magnetic resonance imaging(MRI)examination combined with Gesell score for neurodevelopment in infants with brain injury.Methods 93 infants with brain injury born in our hospital from July 2022 to July 2023 were selected as the research subjects.According to the results of cranial MRI,the 93 infants with brain injury were divided into mild group(n=21),moderate group(n=47),and severe group(n=25).According to the Bayley Infant Development Scale,they were divided into a good prognosis group of 65 cases and a poor prognosis group of 28 cases.Comparisons were made between different degrees of brain injury in infants(MRI parameters such as T_(1) value,T_(2) value,DWI value,and Gesell score),as well as clinical indicators of infants with different prognoses of brain injury,and Pearson correlation analysis,logistic multifactor analysis,and ROC curve analysis were conducted.Results The MRI parameters(T_(1) value,T_(2) value,DWI value)of children in the severe group were significantly higher than those in the moderate and mild groups,Gesell score in severe group was significantly lower than that in moderate group and mild group.There were no statistical differences in gender,birth weight,1 min Apgar score,mode of delivery,and whether there was anemia during pregnancy between the good prognosis and poor prognosis groups;however,there were statistical differences in 5 min Apgar score,T_(1) value,T_(2) value,DWI value,Bayley score,and Gesell score between the good prognosis and poor prognosis groups.Pearson correlation analysis showed that the MRI parameters(T_(1) value,T_(2) value,DWI value)of infants with brain injury were negatively correlated with MDI and PDI,while the Gesell score was positively correlated with MDI and PDI(P<0.05).Logistic multifactor analysis results showed that 5 min Apgar score,T_(1) value,T_(2) value,DWI value,and Gesell score were independent influencing factors of the neurodevelopment prognosis of infants with brain injury.The ROC curve showed that the co

关 键 词：磁共振 Gesell发育量 脑损伤新生儿 神经发育 预后 

分 类 号：R722[医药卫生—儿科]