Department of Neurology, University of New Mexico Health Science Center, Albuquerque, New Mexico 87106, USA.
Pediatr Res. 2011 Mar;69(3):224-9. doi: 10.1203/PDR.0b013e3182091d52.
Neurometabolic sequelae of children born at very LBW (VLBW) are not well characterized in early childhood. Proton magnetic resonance spectroscopy (1H-MRS) and developmental assessments were acquired from children age 18-22 mo (16 VLBW/7 term) and 3-4 y (12 VLBW/8 term) from the anterior cingulate and left frontal periventricular white matter. Metabolites obtained included combined N-acetylaspartylglutamate and N-acetylaspartate (NAA), total choline-containing compounds (Cho), combined glutamate and glutamine (Glx), combined creatine and phosphocreatine (Cr), myoinositol (mI), and the following ratios: NAA/Cr, Cho/Cr, Glx/Cr, mI/Cr, and NAA/Cho. Significant differences were present only in white matter: at 18-22 mo, NAA was decreased in VLBW children (p < 0.04), and at 3-4 y, VLBW children showed lower Cr (p < 0.01), lower NAA/Cho (p < 0.005), higher Glx/Cr (p < 0.02), and higher Cho/Cr (p < 0.005). On developmental testing, VLBW children scored lower on language expression (p < 0.05) and on the A-not-B test of early executive function (p < 0.01) at 18-22 mo and had lower verbal intelligence quotient (IQ) (p < 0.005), performance IQ (p < 0.04), and several measures of early executive function including the bear-dragon test (p < 0.004), gift delay (p < 0.07), and summary categorization score (p < 0.03) at 3-4 y. VLBW children may have neurometabolic and developmental abnormalities that persist at least through early childhood.
极低出生体重儿（VLBW）的儿童在幼儿期的神经代谢后遗症尚未得到很好的描述。从年龄为 18-22 个月（16 名 VLBW/7 名足月）和 3-4 岁（12 名 VLBW/8 名足月）的儿童的前扣带回和左侧额侧脑室周围白质中获得质子磁共振波谱（1H-MRS）和发育评估。获得的代谢物包括组合的 N-乙酰天冬氨酸谷氨酸盐和 N-乙酰天冬氨酸（NAA）、总胆碱含量化合物（Cho）、谷氨酸和谷氨酰胺（Glx）、肌酸和磷酸肌酸（Cr）、肌醇（mI）以及以下比值：NAA/Cr、Cho/Cr、Glx/Cr、mI/Cr 和 NAA/Cho。仅在白质中存在显著差异：在 18-22 个月时，VLBW 儿童的 NAA 降低（p<0.04），而在 3-4 岁时，VLBW 儿童的 Cr 降低（p<0.01），NAA/Cho 降低（p<0.005），Glx/Cr 升高（p<0.02），Cho/Cr 升高（p<0.005）。在发育测试中，VLBW 儿童在 18-22 个月时在语言表达方面得分较低（p<0.05），在早期执行功能的 A 不 B 测试中得分较低（p<0.01），在 3-4 岁时的语言智商（IQ）较低（p<0.005）、操作智商（p<0.04）以及几项早期执行功能测试得分较低，包括熊龙测试（p<0.004）、礼物延迟（p<0.07）和总结分类评分（p<0.03）。VLBW 儿童可能存在神经代谢和发育异常，这些异常至少在幼儿期持续存在。
