Vasiljević Brankica, Maglajlić-Djukić Svjetlana, Stanković Sanja, Lutovacs Dragana, Gojnić Miroslava
Klinicki centar Srbije, Institut za ginekologiju i akuserstvo, Beograd, Srbija.
Vojnosanit Pregl. 2011 Oct;68(10):825-31. doi: 10.2298/vsp1110825v.
BACKGROUND/AIM: The use of color Doppler neurosonography (cD-US) allows simultaneous examination of parenchymal and vascular cerebral structures. Evaluation of cerebral blood flow velocities (CBFV) and vascular resistance are important in assessment of cerebral circulation in neonates with hypoxic ischemic encephalopathy (HIE). The aim of this study was to evaluate the predictive value of cD-US for abnormal neurodevelopmental outcome in the neonates with HIE.
A total of 90 neonates (> 32 weeks gestational age) with HIE were enrolled prospectively. All the neonates with HIE were categorized into three grades according to the Sarnat and Sarnat clinical staging system: mild HIE, moderate HIE, and severe HIE. cD-US was performed simultaneously during the first 24 h of life. Neurodevelopment outcome was assessed at 12 months of age in all the neonates.
The values of CBFV and the values of index resistance (RI) correlated with the severity of HIE (p < 0.0001) and subsequent neurodevelopmental outcome (p < 0.001). We detected a significant difference in values of CBFV and in values of RI between preterm and full-term neonates (p < 0.01). The cut-off value of RI for poor neurodevelopmental outcomes was 0.81.
cD-US could be very useful and safe diagnostic tool for assessing severity of HIE and subsequent adverse neurodevelopmental outcome.
背景/目的:彩色多普勒神经超声检查(cD-US)可同时检查脑实质和脑血管结构。评估脑血流速度(CBFV)和血管阻力对于缺氧缺血性脑病(HIE)新生儿的脑循环评估很重要。本研究的目的是评估cD-US对HIE新生儿异常神经发育结局的预测价值。
前瞻性纳入90例胎龄>32周的HIE新生儿。所有HIE新生儿根据Sarnat和Sarnat临床分期系统分为三个等级:轻度HIE、中度HIE和重度HIE。在出生后24小时内同时进行cD-US检查。所有新生儿在12个月龄时评估神经发育结局。
CBFV值和阻力指数(RI)值与HIE严重程度(p<0.0001)及随后的神经发育结局(p<0.001)相关。我们检测到早产和足月新生儿之间的CBFV值和RI值存在显著差异(p<0.01)。神经发育不良结局的RI临界值为0.81。
cD-US可能是评估HIE严重程度及随后不良神经发育结局的非常有用且安全的诊断工具。