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目的:探讨新生儿窒息复苏后在音乐刺激情况下脑组织的氧合血红蛋白的变化,研究早期脑反应性与智能发育的关系。方法:对深圳市人民医院2005～2007年窒息复苏后的50例新生儿分别在第5～7天采用近红外光谱测定安静状态及音乐刺激后脑组织的氧合血红蛋白,分别按窒息程度分组,并进行组间比较;生后6个月、1岁采用中国标准化的贝利量表(CD-CC)测定MDI和PDI检测智能发育水平,评价早期脑反应性与智能发育的关系。结果:重度窒息患儿生后第5～7天音乐刺激前后脑组织的氧合血红蛋白的变化与对照组及轻度窒息组比较,有统计学差异(P<0.05)。6个月时智能发育情况对比,脑反应性好组分别比脑反应性一般、脑反应性差组MDI评分高8.76分、9.19分;脑反应性好组比脑反应性一般、脑反应性差组PDI评分高8.50分、9.84分。1岁时智能发育情况对比,脑反应性好组比脑反应性一般、脑反应性差组MDI评分高6.31分、8.22分;脑反应性好组比脑反应性一般、脑反应性差组PDI评分高5.69分、7.67分;三组患儿MDI及PDI分值相比有统计学差异(P<0.05)。结论:刺激后脑组织的氧合状态的血红蛋白的改变有助于了解新生儿窒息后的脑反应性;争取尽早通过脑反应性来预测患儿的预后,为脑损害患儿的早期干预治疗提供理论依据。
Objective: To investigate the changes of oxygenated hemoglobin (HbAc) in brain tissue under neonatal asphyxia and to explore the relationship between early cerebral reactivity and intelligence development. Methods: Fifty neonates after resuscitation in Shenzhen People’s Hospital from 2005 to 2007 were measured by near infrared spectroscopy (NIRS) on the 5th and 7th days, respectively. The levels of oxygenated hemoglobin in the brain after music stimulation were determined by the degree of asphyxia 6-month-old and 1-year-old children were examined with MDI and PDI at the age of 1 year using the Chinese standardization Bailey Scale (CD-CC) to evaluate the relationship between early cerebral reactivity and intelligence development. Results: Compared with the control group and the mild asphyxia group, there was a significant difference (P <0.05) in the changes of oxygenated hemoglobin in brain tissue before and after music stimulation in children with severe asphyxia. Six months later, compared with the brain development, the brain responsiveness was higher than that of the brain. The MDI scores of the poor brain responsiveness group were 8.76 and 9.19, respectively. The brain responsiveness was better than the brain reactive and PDI High score 8.50 points, 9.84 points. At 1 year old, compared with the brain development, the brain responsiveness was better than the brain reactivity. The MDI scores of the poor brain response were 6.31 and 8.22 respectively. The brain responsiveness was better than the brain reactivity and poor PDI 5.69 and 7.67 respectively. There was significant difference between MDI and PDI in three groups (P <0.05). Conclusion: The change of oxygenated hemoglobin in the brain tissue after stimulation may be helpful to understand the brain reactivity after neonatal asphyxia; to predict the prognosis of children with cerebral reactivity as early as possible and to provide the theory for the early intervention treatment of children with brain damage in accordance with.