Centre for Perinatal Neuroscience, Brain Sciences Department, Imperial College of Science Technology and Medicine, London, UK
Centre for Perinatal Neuroscience, Brain Sciences Department, Imperial College of Science Technology and Medicine, London, UK.
Arch Dis Child Fetal Neonatal Ed. 2021 Nov;106(6):669-672. doi: 10.1136/archdischild-2020-321164. Epub 2021 May 5.
We examined the association of Total Sarnat Score (TSS) with brain injury on neonatal magnetic resonance (MR) and adverse neurodevelopmental outcome (NDO) (death or moderate or severe disability) at 2 years of age in 145 infants undergoing therapeutic hypothermia for neonatal encephalopathy. TSS was associated with basal ganglia/thalamic injury on conventional MR (p=0.03) and thalamic N-acetyl aspartate on MR spectroscopy (R=0.16, p=0.004) at 2 weeks of age, and Bayley Composite Cognitive (R=0.18, p=0.01), Motor (R=0.15, p=0.02) and Language (R=0.11, p=0.01) Scores at 2 years of age after adjustment for seizures at the time of neurological assessment. The accuracy of TSS (area under the curve (AUC)=0.71) for predicting adverse NDO was similar to the modified Sarnat staging (AUC=0.72). TSS of >12 within 6 hours of birth indicated high risk of adverse NDO, while TSS of <4 indicated intact survival and was reassuring of a good outcome among cooled infants.
我们研究了在 145 名接受治疗性低温治疗的新生儿脑病婴儿中，总 Sarnat 评分（TSS）与新生儿磁共振成像（MR）上的脑损伤以及 2 岁时的不良神经发育结局（死亡或中度或重度残疾）之间的关联。TSS 与常规 MR 上的基底节/丘脑损伤（p=0.03）和 MR 光谱上的丘脑 N-乙酰天门冬氨酸（R=0.16，p=0.004）在 2 周龄时相关，并且在调整神经评估时的癫痫发作后，在 2 岁时的贝利综合认知（R=0.18，p=0.01）、运动（R=0.15，p=0.02）和语言（R=0.11，p=0.01）评分相关。TSS（曲线下面积（AUC）=0.71）预测不良 NDO 的准确性与改良 Sarnat 分期（AUC=0.72）相似。出生后 6 小时内 TSS >12 表明不良 NDO 的风险较高，而 TSS <4 表明存活完整，并为接受冷却治疗的婴儿的良好结局提供了保证。
