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目的通过对活体脑组织的代谢监测,了解脑组织早期缺氧的损伤情况。方法采用新生儿行为神经评分(neonatal behaviors neurological assessment,NBNA)对12例有宫内窘迫的新生儿及对照组新生儿进行评估,采用磁共振波谱扫描观察脑组织乳酸(lactate,Lac)、肌苷(creatinine,Cr)、N-乙酰天冬氨酸(N-acetylaspartate,NAA)等改变。结果窘迫组新生儿NBNA评分(35·3±1·37)明显低于对照组(38·8±0·75)(t=3·25,P<0·05)。两组间磁共振波谱Cr峰值比较差异无统计学意义(P>0·05),窘迫组基底核及颞叶皮质中Lac峰值及Lac/Cr比值明显高于对照组(P<0·01),两组间NAA峰值及NAA/Cr比值比较差异无统计学意义(P>0·05)。窘迫组NBNA评分分值与基底核Lac/Cr比值呈负相关(r=-0·547,P<0·05)。结论基底核等磁共振波谱Lac峰值及Lac/Cr比值可能在新生儿脑组织缺氧后早期发生变化。
Objective To understand the damage of early hypoxia in brain tissue through the metabolic monitoring of living brain tissue. Methods Neonates of 12 neonates with intrauterine distress and control group were evaluated by neonatal behaviors neurological assessment (NBNA). Magnetic resonance spectroscopy was used to observe the changes of brain lactate (Lac), inosine (creatinine, Cr), N-acetylaspartate (NAA) and other changes. Results The neonatal NBNA score (35.3 ± 1.37) in distress group was significantly lower than that in control group (38.8 ± 0.75) (t = 3.25, P <0.05). There was no significant difference in peak Cr value of MR between the two groups (P> 0.05), and the Lac peak and Lac / Cr ratio in the basilar and temporal cortex of the embarrassed group were significantly higher than those in the control group (P <0.01) There was no significant difference in NAA peak and NAA / Cr ratio between the two groups (P> 0.05). The score of NBNA in distress group was negatively correlated with Lac / Cr ratio (r = -0.547, P <0.05). Conclusions Lacustrine peak and Lac / Cr ratio in MRI and other basal nuclei may change early in the neonatal brain tissue after hypoxia.