基于功能性近红外光谱成像的新生儿缺氧缺血性脑病早期脑功能网络特征  

Early functional brain network characteristics in neonatal hypoxic-ischemic encephalopathy assessed by functional near-infrared spectroscopy

作　　者：王子鸣 赵卓宇 赵玲 周佳雨 蒋莹莹 王来栓[1] Wang Ziming;Zhao Zhuoyu;Zhao Ling;Zhou Jiayu;Jiang Yingying;Wang Laishuan(Department of Neonatal Medical Center,Children's Hospital of Fudan University,Children's National Medical Center,National Health Commission Key Laboratory of Neonatal Diseases,Shanghai 201102,China)

机构地区：[1]复旦大学附属儿科医院新生儿诊疗中心,国家儿童医学中心,国家卫生健康委员会新生儿疾病重点实验室,上海201102

出　　处：《中华围产医学杂志》2025年第4期273-279,共7页Chinese Journal of Perinatal Medicine

摘　　要：目的探讨功能性近红外光谱成像(functional near-infrared spectroscopy,fNIRS)对新生儿缺氧缺血性脑病(hypoxic-ischemic encephalopathy,HIE)的脑功能评估作用。方法本研究为病例对照研究,选择2023年3月至2024年8月入住复旦大学附属儿科医院新生儿诊疗中心,并完成fNIRS检测的15例中重度HIE患儿为HIE组,以及同期完成fNIRS检测的15例无神经系统疾病的足月儿作为对照组。基于静息态fNIRS数据,进行脑功能连接网络构建并分析其拓扑特征。采用独立样本t检验、Mann-Whitney U检验、方差分析及χ^(2)检验进行统计学分析。结果HIE组与对照组相比,全脑功能连接强度下降[0.15(0.05~0.26)与0.24(0.13~0.35),Z=-7.66,P<0.001]。全局网络属性方面,2组新生儿小世界指数均大于1,组间差异无统计学意义(1.17±0.05与1.14±0.05,t=2.02,P=0.050);HIE组的最短路径长度(6.22±0.52与13.74±0.49,t=48.18)、全局效率(0.26±0.04与0.30±0.05,t=2.50)和归一化最短路径(1.50±0.07与1.62±0.22,t=2.43)较对照组均下降(P值均<0.05);2组的聚类系数和局部效率差异均无统计学意义(P值均>0.05)。局部网络属性方面,HIE组左半球(0.30±0.06与0.35±0.05,t=2.47)和右半球(0.30±0.06与0.37±0.06,t=2.68)的节点效率均显著小于对照组的对应半球(P值均>0.05);同一组别中左右半球节点效率差异均无统计学意义(P值均>0.05)。结论fNIRS能够评估HIE脑功能特征,有助于HIE早期脑功能损伤的评估。Objective To investigate the clinical utility of functional near-infrared spectroscopy(fNIRS)in evaluating cerebral function in neonates with hypoxic-ischemic encephalopathy(HIE).Methods This was a case-control study.Fifteen neonates with moderate to severe HIE who were admitted to the Department of Neonatal Medical Center,Children's Hospital of Fudan University from March 2023 to August 2024 and completed fNIRS testing were selected as the HIE group,and 15 full-term infants without neurological diseases and completed fNIRS testing were selected as the control group during the same period.Resting-state fNIRS data were acquired to construct cerebral functional connectivity networks and topological properties were analyzed.Statistical analyses included independent t-tests,Mann-Whitney U tests,analysis of variance,and Chi-square tests.Results Compared with controls,the HIE group exhibited significantly reduced global functional connectivity strength[0.15(0.05-0.26)vs.0.24(0.13-0.35),Z=-7.66,P<0.001].Both groups demonstrated small-world network properties,with no intergroup difference(1.17±0.05 vs.1.14±0.05,t=2.02,P=0.050).The HIE group showed decreased shortest path length(6.22±0.52 vs.13.74±0.49,t=48.18,P<0.001),global efficiency(0.26±0.04 vs.0.30±0.05,t=2.50,P=0.018)and normalized shortest path length(1.50±0.07 vs.1.62±0.22,t=2.43,P=0.020).No differences were observed in the clustering coefficient or local efficiency between the two groups.Regional analysis revealed reduced nodal efficiency in both left(0.30±0.06 vs.0.35±0.05,t=2.47,P=0.021)and right hemispheres(0.30±0.06 vs.0.37±0.06,t=2.68,P=0.013)in HIE neonates compared with that of the corresponding hemispheres in the control group.The intra-group comparison showed no statistical significance in node efficiency between the left and right hemispheres(both P>0.05).Conclusion fNIRS captures functional network signatures in HIE,demonstrating clinical potential for early detection of cerebral dysfunction in neonates with hypoxic-ischemic injury.

关 键 词：新生儿 缺氧缺血性脑病 功能性近红外光谱成像 脑功能网络 图论 

分 类 号：R722.1[医药卫生—儿科]