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极低出生体重早产儿胼胝体和小脑蚓部的线性生长。

Linear growth of corpus callosum and cerebellar vermis in very-low-birth-weight preterm infants.

机构信息

Department of Pediatrics, Taipei City Hospital, Heping FuYou Branch, Taipei, Taiwan; Department of Pediatrics, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan.

Department of Pediatrics, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan.

出版信息

J Formos Med Assoc. 2020 Aug;119(8):1292-1298. doi: 10.1016/j.jfma.2020.04.001. Epub 2020 Apr 21.

Abstract

BACKGROUND/PURPOSE: Impaired growth of the corpus callosum (CC) and cerebellar vermis (CV) is associated with poorer neurodevelopmental outcomes in preterm infants. However, references on the postnatal growth rate of the CC and CV by sonography are limited. The aim of this study is to assess the normal linear growth of CC and CV using a serial cranial ultrasound.

METHODS

We prospectively enrolled preterm infants with very low birth weight from September 2008 to December 2009 after excluding those with congenital anomalies or diseases affecting the brain parenchyma. Serial sonographic measurements of the CC and CV were performed according to the standard protocol. Scheduled comprehensive neurodevelopmental evaluations were performed till the corrected age of 2 years. We excluded those with significant brain damages or poor neurodevelopmental outcomes in the final analysis. The growth rate was estimated using the loess smoothing curve and linear regression analysis.

RESULTS

Among the 86 enrolled neonates, 14 with significant brain damage and 8 with poor neurodevelopmental outcomes were excluded from the final analysis. The growth rate of the CC length was 1.72 (95% confidence interval [CI]: 1.24-2.20) and 0.57 (95% CI: 0.33-0.80) mm per week before and after the postmenstrual age of 30.5 weeks, respectively. The growth rate of the CV length was 0.78 (95% CI: 0.68-0.89) mm per week.

CONCLUSION

We proposed reference values of the normal linear growth rate of the CC and CV lengths in very-low-birth-weight preterm infants using the serial cranial ultrasound.

摘要

背景/目的:胼胝体(CC)和小脑蚓部(CV)生长受损与早产儿神经发育结局较差有关。然而,超声对 CC 和 CV 出生后生长速度的参考资料有限。本研究旨在使用连续头颅超声评估 CC 和 CV 的正常线性生长。

方法

我们前瞻性纳入了 2008 年 9 月至 2009 年 12 月出生的极低出生体重早产儿,排除了伴有先天畸形或影响脑实质疾病的患儿。按照标准方案对 CC 和 CV 进行连续超声测量。在矫正年龄 2 岁时进行预定的全面神经发育评估。我们排除了那些有显著脑损伤或神经发育不良结局的患儿。使用局部加权回归(loess)平滑曲线和线性回归分析估计生长速度。

结果

在 86 名入组新生儿中,14 名患儿因显著脑损伤和 8 名患儿因神经发育不良结局被排除在最终分析之外。在矫正胎龄 30.5 周之前,CC 长度的生长速度分别为 1.72(95%置信区间[CI]:1.24-2.20)和 0.57(95%CI:0.33-0.80)mm/周。CV 长度的生长速度为 0.78(95%CI:0.68-0.89)mm/周。

结论

我们使用连续头颅超声提出了极低出生体重早产儿 CC 和 CV 长度正常线性生长速度的参考值。

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