本文選題：嬰兒 + 新生　； 參考：《寧夏醫(yī)科大學(xué)》2014年碩士論文

【摘要】：目的分析足月新生兒氫質(zhì)子磁共振波譜(~1H-MRS)腦組織各代謝產(chǎn)物的變化,評(píng)估其在足月新生兒缺氧缺血性腦病(hypoxic-ischemic encephalopathy,HIE)中的臨床應(yīng)用價(jià)值。探討足月新生兒缺氧缺血性腦病(HIE)~1H-MRS指標(biāo)與臨床NBNA評(píng)分的相關(guān)性。方法納入足月HIE患兒101例,29例日齡72 h、33例日齡4~7天、39例日齡8~14天;另選取同期足月健康新生兒37名作為正常對(duì)照。對(duì)所有新生兒行常規(guī)MR及~1H-MRS檢查,根據(jù)MRI表現(xiàn)對(duì)HIE進(jìn)行分級(jí),比較不同程度HIE患兒和正常新生兒N-乙酰天門(mén)冬氨酸(N-acetylaspartate,NAA)/膽堿復(fù)合物(choline,Cho)、NAA/肌酸(creatine Cr)及Cho/Cr差異;對(duì)HIE患兒行新生兒行為神經(jīng)測(cè)定(neonatal behavioral neurological assessment,NBNA)評(píng)分,比較不同程度HIE患兒NBNA評(píng)分差異;評(píng)價(jià)~1H-MRS指標(biāo)與NBNA評(píng)分的相關(guān)性。結(jié)果不同日齡中重度HIE患兒基底節(jié)NAA/Cho和NAA/Cr、額葉NAA/Cho均低于相應(yīng)日齡正常新生兒,(P均0.05)。不同日齡重度HIE患兒NBNA評(píng)分均低于中度HIE患兒,差異有統(tǒng)計(jì)學(xué)意義(P均0.05)。HIE患兒基底節(jié)NAA/Cho和NAA/Cr、額葉NAA/Cho與NBNA評(píng)分呈正相關(guān)(r=0.238,0.221,0.202;P均0.05)結(jié)論HIE患兒~1H-MRS與NBNA評(píng)分顯著相關(guān),二者結(jié)合有助于早期檢出足月HIE患兒及評(píng)價(jià)腦損傷嚴(yán)重程度。
[Abstract]:Objective to analyze the changes of metabolites in brain tissue of full-term neonates with proton magnetic resonance spectroscopy (1H-MRS) and to evaluate their clinical value in the diagnosis of hypoxic-ischemic encephalopathy (HIEE) of term neonates. To investigate the correlation between 1H-MRS and clinical NBNA score in term neonates with hypoxic ischemic encephalopathy (HIE). Methods A total of 101 children with full-term HIE were enrolled in this study. Among them, 29 cases were 72 hours old, 33 cases were 4 days old, 7 days old, 39 cases were 8 days old and 14 days old, and 37 healthy newborns in the same period were selected as normal control. All neonates were examined with conventional Mr and 1H-MRS. According to the MRI findings, HIE was graded to compare the difference of NAAA / creatine Cr (NAAA / creatine Cr) and Chorcr in NacetylaspartateNacetylaspartate / choline complex (N-acetylaspartate NAA / choline complex) with different degrees of HIE and normal neonates. To evaluate the correlation between NBNA score and neonatal behavioral nerve test (NBNA) score, to compare the difference of NBNA score in different degree of HIE children, and to evaluate the correlation between 1H-MRS index and NBNA score. Results NAA / Cho and NAA / Cr in basal ganglia and NAA / Cr in frontal lobe of children with moderate and severe HIE at different days were lower than those in normal neonates of corresponding day age (P < 0.05). The NBNA scores of severe HIE children at different ages were lower than those of moderate HIE children. The difference was statistically significant (P < 0.05). There was a positive correlation between NAA / Cho and NAA- / Cr in basal ganglia, and a positive correlation between NAA / Cho and NBNA scores in frontal lobe NAA / Cho and NBNA scores in HIE children (P < 0.05). The combination of the two methods is helpful for early detection of term HIE and evaluation of the severity of brain injury.
【學(xué)位授予單位】：寧夏醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R742;R445.2

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