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用质子磁共振光谱法(1H-MRS)比较了小于胎龄儿(SGA)与接近正常胎龄儿(AGA)的大脑发育及代谢状况。据推测,由于胎盘机能不全所导致宫内生长迟缓与脑代谢改变有关,而且在幼儿2岁时通常出现大脑发育不良状况,我们对此假设进行了验证。26例AGA及14例SGA(出生前体重<2.3 kg)被纳入本研究,所有产儿均经超声检查没有明显异常。在孕32-41周时,给予1H-MRS及磁共振检查。用1H-MRS方法主要检查了基底节及脑室周的白质。分别对AGA组及SGA组的乙酰天冬氨酸/胆碱(NAA/Cho)、乳酸盐/胆碱、肌醇/胆碱(ml/Cho)以及谷氨酸-谷氨酰胺-γ-氨基丁酸/胆碱(Glx/Cho)进行比较。在检查者2岁时用Grif- fith发育指数(DQ)进行评分。应用Griffith发育指数(AGA,104±10;SGA,99±9)和用磁共振检查所得到的大脑发育状况对两组进行比较,结果显示AGA和SGA 组没有显著差别。同样,NAA/Cho、ml/Cho、Glx/Cho的比值在两组间也没有差异。从第32周开始到第41周, NAA/Cho比值增加,而ml/Cho比值在两组中均下降。AGA组与SGA组相比较,在脑代谢、大脑发育及DQ 评分方面均没有差异。
Brain development and metabolic status of SGA and AGA were compared by proton magnetic resonance spectroscopy (1H-MRS). It is speculated that due to placental insufficiency caused by intrauterine growth retardation and changes in brain metabolism, and 2-year-old children usually appear in the brain dysplasia, we hypothesize this hypothesis. 26 cases of AGA and 14 cases of SGA (birth weight <2.3 kg) were included in this study, all children were ultrasonographically no significant abnormalities. At 32-41 weeks of pregnancy, 1H-MRS and magnetic resonance imaging were performed. The 1H-MRS method was used to examine the basal ganglia and periventricular white matter. The activities of NAA / Cho, lactate / choline, inositol / choline (ml / Cho) and glutamate-glutamine- Aminobutyrate / choline (Glx / Cho) were compared. Scores were assessed with the Grif- fith Developmental Index (DQ) at 2 years of age. The Griffith Developmental Index (AGA, 104 ± 10; SGA, 99 ± 9) and brain development obtained by magnetic resonance imaging were compared between the two groups and the results showed no significant differences between the AGA and SGA groups. Similarly, the NAA / Cho, ml / Cho, Glx / Cho ratio did not differ between the two groups. From week 32 to week 41, the NAA / Cho ratio increased, while the ml / Cho ratio decreased in both groups. There was no difference in brain metabolism, brain development and DQ scores between the AGA group and the SGA group.