轻度脑病婴儿的前瞻性研究：PRIME研究
Prospective research on infants with mild encephalopathy: the PRIME study.
作者信息
Prempunpong C, Chalak L F, Garfinkle J, Shah B, Kalra V, Rollins N, Boyle R, Nguyen K-A, Mir I, Pappas A, Montaldo P, Thayyil S, Sánchez P J, Shankaran S, Laptook A R, Sant'Anna G
机构信息
Mahidol University, Bangkok, Thailand.
University of Texas Southwestern Medical Center, Dallas, TX, USA.
出版信息
J Perinatol. 2018 Jan;38(1):80-85. doi: 10.1038/jp.2017.164. Epub 2017 Nov 2.
Abstract
OBJECTIVE
To determine short-term outcomes of infants with evidence of hypoxia-ischemia at birth and classified as mild neonatal encephalopathy (NE) at <6 h of age.
STUDY DESIGN
Prospective multicenter study. Mild NE was defined as ⩾1 abnormal category in modified Sarnat score. Primary outcome was any abnormality on early amplitude integrated electroencephalogram (aEEG) or seizures, abnormal brain magnetic resonance imaging (MRI) or neurological exam at discharge.
RESULTS
A total of 54/63 (86%) of enrolled infants had data on components of the primary outcome, which was abnormal in 28/54 (52%): discontinuous aEEG (n=4), MRI (n=9) and discharge exam (n=22). Abnormal tone and/or incomplete Moro were the most common findings. MRI abnormalities were confined to cerebral cortex but two infants had basal ganglia and/or thalamus involvement. The 18 to 24 months follow-up is ongoing.
CONCLUSIONS
A larger than expected proportion of mild NE infants with abnormal outcomes was observed. Future research should evaluate safety and efficacy of neuroprotection for mild NE.
摘要
目的
确定出生时有缺氧缺血证据且在出生后<6小时被分类为轻度新生儿脑病（NE）的婴儿的短期预后。
研究设计
前瞻性多中心研究。轻度NE定义为改良Sarnat评分中≥1个异常类别。主要结局为早期振幅整合脑电图（aEEG）或惊厥异常、出院时脑磁共振成像（MRI）异常或神经学检查异常。
结果
共有54/63（86%）的入组婴儿有主要结局各组成部分的数据，其中28/54（52%）异常：aEEG不连续（n = 4）、MRI（n = 9）和出院检查（n = 22）。异常肌张力和/或不完全拥抱反射是最常见的表现。MRI异常局限于大脑皮层，但有两名婴儿累及基底神经节和/或丘脑。18至24个月的随访正在进行中。
结论
观察到轻度NE婴儿出现异常结局的比例高于预期。未来的研究应评估针对轻度NE的神经保护的安全性和有效性。
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