新生儿轻度缺氧缺血性脑病后的脑损伤——三级围产期中心的十年经验
Brain injury following mild hypoxic-ischemic encephalopathy in neonates-Ten-year experience in a tertiary perinatal center.
作者信息
Imanishi Toshiyuki, Shimizu Masaki, Sumiya Wakako, Kanno Chika, Kanno Masayuki, Kanno Masami, Kawabata Ken
机构信息
Division of Neonatology, Department of Maternal and Perinatal Center, Saitama Children's Medical Center, Saitama, Japan.
出版信息
J Perinatol. 2022 Dec;42(12):1630-1636. doi: 10.1038/s41372-022-01486-3. Epub 2022 Aug 11.
OBJECTIVE
We aimed to evaluate abnormal magnetic resonance imaging (MRI) findings in neonates with mild hypoxic-ischemic encephalopathy (HIE).
STUDY DESIGN
This was a single-center, retrospective study of mild HIE conducted from 2011 to 2020. Almost all neonates with mild HIE received management targeted to a temperature of 36 ± 0.5°C for 72 h and underwent MRI (135 of 145). We evaluated medical records and assessed amplitude-integrated electroencephalography (aEEG).
RESULT
All participants survived until discharge. Abnormal MRI findings were present in 23/135 (17%) neonates. The normal versus abnormal MRI-finding groups had similar characteristics, except discontinuous aEEG patterns (p = 0.002) and inotropic drugs (p = 0.035). Regression analyses showed discontinuous aEEG patterns (odds ratio = 19.3, 95% confidence interval=1.88-197, p = 0.013) being associated with higher odds of abnormal MRI findings.
CONCLUSION
Our study suggests that a discontinuous aEEG pattern is associated with abnormal MRI findings and can be used to discuss the definition of mild HIE.
目的
我们旨在评估轻度缺氧缺血性脑病（HIE）新生儿的磁共振成像（MRI）异常表现。
研究设计
这是一项对2011年至2020年期间轻度HIE进行的单中心回顾性研究。几乎所有轻度HIE新生儿均接受了目标体温为36±0.5°C、持续72小时的治疗，并接受了MRI检查（145例中有135例）。我们评估了病历并进行了振幅整合脑电图（aEEG）评估。
结果
所有参与者均存活至出院。135例新生儿中有23例（17%）存在MRI异常表现。MRI表现正常组与异常组具有相似的特征，但aEEG模式不连续（p = 0.002）和使用了血管活性药物（p = 0.035）的情况除外。回归分析显示，aEEG模式不连续（优势比=19.3，95%置信区间=1.88 - 197，p = 0.013）与MRI异常表现的较高几率相关。
结论
我们的研究表明，aEEG模式不连续与MRI异常表现相关，可用于讨论轻度HIE的定义。
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