轻度缺氧缺血性脑病与长期神经发育结局——一项系统综述
Mild hypoxic ischaemic encephalopathy and long term neurodevelopmental outcome - A systematic review.
作者信息
Conway J M, Walsh B H, Boylan G B, Murray D M
机构信息
Irish Central for Fetal and Neonatal Translational Research-INFANT Centre, Department of Pediatrics and Child Health, University College Cork, Cork University Hospital, Wilton, Cork, Ireland.
Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Boston, MA, USA.
出版信息
Early Hum Dev. 2018 May;120:80-87. doi: 10.1016/j.earlhumdev.2018.02.007. Epub 2018 Feb 26.
AIMS
Hypoxic ischaemic encephalopathy (HIE) remains a significant cause of long term neurodisability despite therapeutic hypothermia (TH). Infants with mild HIE, representing 50% of those with HIE, are perceived as low risk and are currently not eligible for TH [1]. This review examines the available evidence of outcome in term infants with mild HIE.
METHODS
Medline, Embase and Cochrane Clinical Trials databases were searched in March 2017. Studies with well-defined HIE grading at birth and standardised neurodevelopmental assessment at ≥18 months were included. Abnormal outcome was defined as death, cerebral palsy or standardised neurodevelopmental test score more than 1 standard deviation below the mean.
RESULT
Twenty studies were included. Abnormal outcome was reported in 86/341 (25%) of infants. There was insufficient evidence to examine the effect of TH on outcome.
CONCLUSION
A significant proportion of infants with mild HIE have abnormal outcome at follow up.
目的
尽管有亚低温治疗（TH），缺氧缺血性脑病（HIE）仍是导致长期神经残疾的重要原因。轻度HIE婴儿占HIE患儿的50%，被视为低风险，目前不符合亚低温治疗的条件[1]。本综述探讨了足月轻度HIE婴儿预后的现有证据。
方法
2017年3月检索了Medline、Embase和Cochrane临床试验数据库。纳入出生时HIE分级明确且在≥18个月时进行标准化神经发育评估的研究。异常结局定义为死亡、脑瘫或标准化神经发育测试得分低于平均值超过1个标准差。
结果
纳入20项研究。86/341（25%）的婴儿报告有异常结局。没有足够的证据来检验亚低温治疗对结局的影响。
结论
相当一部分轻度HIE婴儿在随访时有异常结局。
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