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| 磁共振波谱技术及脑干听觉诱发电位在新生儿早期胆红素脑损伤中的评估作用 |
| Early assessment of neonatal bilirubin brain injury with help of magnetic resonance spectroscopy (MRS) and brainstem auditory evoked potential (BAEP) |
| 投稿时间：2016-11-09 |
| DOI：10.3969/j.issn.1000-0399.2017.05.005 |
| 中文关键词: 新生儿 胆红素脑损伤 磁共振波谱 脑干听觉诱发电位 |
| 英文关键词: Neonate Bilirubin encephalopathy Magnetic resonance spectrum Brainstem auditory evoked potential |
| 基金项目:安徽省卫计委科研项目（项目编号：14FR019） |
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| 中文摘要: |
| 目的 探讨新生儿胆红素脑损伤时磁共振波谱技术（MRS）及脑干听觉诱发电位（BAEP）的变化特征，为新生儿胆红素脑损伤的早期干预治疗提供临床依据。方法 选取2013年7月至2016年3月入住安徽省儿童医院新生儿科114例高胆红素血症患儿为研究对象，根据头颅核磁共振（MRI）检查是否有脑损伤，分为观察组（胆红素脑损伤）和对照组（无脑损伤），同时分别进行MRS分析及BAEP检测，MRS分析所测定的代谢产物包括：N-乙酰天门冬氨酸（NAA）；肌酸复合物（Cr）；胆碱复合物（Cho）；并以Cr的峰下面为内参照物，计算NAA/Cr、Cho/Cr、NAA/Cho比值。比较两组MRS及BAEP的差异。结果 观察组NAA/Cr比值（1.34±0.26）较对照组（1.50±0.36）低，差异有统计学意义（P<0.05），NAA/Cho及Cho/Cr在两组之间差异无统计学意义（P>0.05）；观察组BAEP异常率明显高于对照组，差异有统计学意义（P<0.05），两组之间血清总胆红素水平差异无统计学意义（P>0.05）。结论 在MRI基础上，MRS联合BAEP检查有助于新生儿胆红素脑损伤的早期判断。 |
| 英文摘要: |
| Objective To investigate the extent of neonatal bilirubin brain injury by observing the changes in magnetic resonance spectroscopy (MRS) characterization and brainstem auditory evoked potential (BAEP) for the early intervention treatment of neonatal bilirubin encephalopathy and the provision of evidence for further treatment. Methods A total of 114 cases with hyperbilirubinemia were chosen from Anhui Provincial Children's Hospital during Jul 2013 to Mar 2016, and were divided into the observation group (bilirubin brain injury group) and the control group by magnetic resonance imaging (MRI). MRS analysis and BAEP were determined in both groups. The metabolic products N-acetyl aspartate (NAA), Creatine (Cr) and Choline (Cho) were measured by MRS analysis. Analysis of the changes in the results obtained by BAEP and characteristics of MRS in neonatal bilirubin brain injury was performed. The peak below Cr was taken as the internal reference to calculate NAA/Cr, Cho/Cr and NAA/Cho ratios. Results In observation group, NAA/Cr ratios(1.34±0.26) were significantly lower than those in control group(1.50±0.36) with a statistically significant difference (P<0.05). While the differences between the NAA/Cho and Cho/Cr ratios of the two groups were not statistically significant (P>0.05). In the observation group, the abnormal rate of BAEP was higher than that of the control group with a statistically significant difference (P<0.05). Differences in the serum total bilirubin levels between the two groups were not statistically significant. Conclusion The analysis on the basis of conventional MRI, combined with MRS and BAEP presents more conducive and helpful results for early stage diagnosis and treatment of neonatal bilirubin brain injury. |
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