Chen Chih-Cheng, Huang Chung-Bin, Chung Mei-Yung, Huang Li-Tong, Yang Chun-Yuh
Section of Neonatology, Chang-Gung Medical Center, Kaohsiung, Taiwan.
Am J Perinatol. 2004 Nov;21(8):483-9. doi: 10.1055/s-2004-835966.
Periventricular leukomalacia (PVL) is one of the most commonly seen neuropathologic lesions and is related to many neurodevelopmental handicaps in premature infants. Periventricular echogenicities (PVE) are considered to be at the milder end of the spectrum of PVL, and thus might affect the neurodevelopment of the preterm infants as well. In this retrospective cohort study medical records of 257 preterm infants who were discharged from our neonatal intensive care unit (NICU) during October 1996 to August 2000 were reviewed. A total of 114 records of preterm infants fulfilling our criteria were included in the survey. On the basis of the craniosonographic findings and birth history, the candidates were divided into three subgroups: group 1 (control) included infants with normal craniosonographic image during the neonatal period; group 2 included infants with PVEs for < 2 weeks during the neonatal period; group 3 included infants with PVEs> or = 2 weeks during the neonatal period. Neurodevelopmental assessment using the Bayley Scale of Infant Development II at 6, 12, and 18 months of corrected age of each group was compared. There were no significant differences among the three groups in gestational age, birth weight, and gender prevalence. Infants in group 3 had lower Mental Developmental Index and Psychomotor Developmental Index scores as compared with those in groups 1 and 2 at 6 ( p< 0.01), 12 ( p < 0.001), and 18 ( p < 0.01) months of corrected age, respectively. In conclusion, infants with PVEs that persisted for at least a 2-week period have significantly higher risk of delayed developmental outcomes as compared with infants with normal craniosonography or infants with PVEs that persisted for less than 2 weeks. It might be prudent to arrange therapeutic intervention for rehabilitation to these high-risk infants as early as possible to reduce the intensity of possible handicap in the future.
脑室周围白质软化（PVL）是最常见的神经病理学病变之一，与早产儿的许多神经发育障碍有关。脑室周围回声增强（PVE）被认为处于PVL谱系较轻的一端，因此也可能影响早产儿的神经发育。在这项回顾性队列研究中，我们查阅了1996年10月至2000年8月期间从我们新生儿重症监护病房（NICU）出院的257名早产儿的病历。共有114份符合我们标准的早产儿记录被纳入调查。根据头颅超声检查结果和出生史，将这些婴儿分为三个亚组：第1组（对照组）包括新生儿期头颅超声图像正常的婴儿；第2组包括新生儿期PVE持续时间小于2周的婴儿；第3组包括新生儿期PVE持续时间大于或等于2周的婴儿。比较了每组在矫正年龄6个月、12个月和18个月时使用贝利婴儿发育量表第二版进行的神经发育评估。三组在胎龄、出生体重和性别患病率方面没有显著差异。与第1组和第2组相比，第3组婴儿在矫正年龄6个月（p<0.01）、12个月（p<0.001）和18个月（p<0.01）时的智力发育指数和精神运动发育指数得分较低。总之，与头颅超声正常的婴儿或PVE持续时间小于2周的婴儿相比，PVE持续至少2周的婴儿发育延迟的风险显著更高。尽早为这些高危婴儿安排康复治疗干预，以降低未来可能出现的残疾程度，可能是明智的。
