声学结构定量技术评估新生儿缺氧缺血性脑损伤的临床价值
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摘要
目的探讨声学结构定量(ASQ)技术对新生儿缺氧缺血性脑损伤程度的评估价值。方法收集我院出生及新生儿重症监护病房住院的新生儿50例,其中正常对照组26例,轻度窒息组13例,缺氧缺血性脑病组11例;应用ASQ软件对各组新生儿颅脑声像图进行定量分析,获取蓝色及红色曲线均数、众数、标准差、蓝红曲线下面积比7个参数,评估ASQ各参数与缺氧缺血性脑损伤程度的相关性。结果各组间除蓝红曲线下面积比外,其余ASQ参数比较差异均有统计学意义(均P<0.05);缺氧缺血性脑病组蓝色及红色曲线均数、众数、标准差与正常对照组比较,差异均有统计学意义(均P<0.05);缺氧缺血性脑病组蓝色曲线均数、众数与轻度窒息组比较,差异均有统计学意义(均P<0.05);轻度窒息组红色曲线均数、众数与正常对照组比较,差异均有统计学意义(均P<0.05)。蓝色及红色曲线均数、众数、标准差与缺氧缺血性脑损伤程度均呈正相关,其中蓝色曲线均数与脑损伤程度的相关性最好(r=0.854,P<0.001),且其诊断缺氧缺血性脑病新生儿的ROC曲线下面积为0.901,敏感性为90%。结论 ASQ参数与新生儿缺氧缺血性脑损伤程度呈正相关,具有较高的临床评估价值。
Objective To investigate the value of acoustic structural quantification(ASQ)technique in evaluating the degree of hypoxic-ischemic brain damage in neonates. Methods Fifty newborns born in our hospital and hospitalized in NICU were collected,of which 26 were normal newborns(normal control group),13 were mild asphyxia group and 11 were hypoxicischemic encephalopathy group. Quantitative analysis of craniocerebral ultrasonography was made by ASQ software,and7 parameters of blue and red curve average,mode,standard deviation,area ratio under blue-red curve were obtained to evaluate the correlation between ASQ parameters and the degree of hypoxic-ischemic brain damage.Results There were significant differences in average,mode and standard deviation of blue and red curves among the three groups(all P<0.05). The average,mode and standard deviation of blue and red curves in hypoxic-ischemic encephalopathy group were significantly different from those in normal control group(all P<0.05). The average and mode of blue curves in hypoxic-ischemic encephalopathy group were significantly different from those in mild asphyxia group(all P<0.05). The average and mode of red curves in mild asphyxia group were significantly different from those in normal control group(all P<0.05). The difference was increased with the severity of brain injury. The average,mode and standard deviation of blue and red curves were positively correlated with the severity of hypoxic-ischemic brain damage,and the best correlation was found between the average of blue curves and the severity of brain injury(r=0.854,P<0.001). The area under the ROC curve was 0.901 and the sensitivity was90% for the diagnosis of hypoxic-ischemic encephalopathy.Conclusion ASQ parameters were positively correlated with the degree of neonatal hypoxic-ischemic brain damage,which has high clinical evaluation value.
Objective To investigate the value of acoustic structural quantification(ASQ)technique in evaluating the degree of hypoxic-ischemic brain damage in neonates. Methods Fifty newborns born in our hospital and hospitalized in NICU were collected,of which 26 were normal newborns(normal control group),13 were mild asphyxia group and 11 were hypoxicischemic encephalopathy group. Quantitative analysis of craniocerebral ultrasonography was made by ASQ software,and7 parameters of blue and red curve average,mode,standard deviation,area ratio under blue-red curve were obtained to evaluate the correlation between ASQ parameters and the degree of hypoxic-ischemic brain damage.Results There were significant differences in average,mode and standard deviation of blue and red curves among the three groups(all P<0.05). The average,mode and standard deviation of blue and red curves in hypoxic-ischemic encephalopathy group were significantly different from those in normal control group(all P<0.05). The average and mode of blue curves in hypoxic-ischemic encephalopathy group were significantly different from those in mild asphyxia group(all P<0.05). The average and mode of red curves in mild asphyxia group were significantly different from those in normal control group(all P<0.05). The difference was increased with the severity of brain injury. The average,mode and standard deviation of blue and red curves were positively correlated with the severity of hypoxic-ischemic brain damage,and the best correlation was found between the average of blue curves and the severity of brain injury(r=0.854,P<0.001). The area under the ROC curve was 0.901 and the sensitivity was90% for the diagnosis of hypoxic-ischemic encephalopathy.Conclusion ASQ parameters were positively correlated with the degree of neonatal hypoxic-ischemic brain damage,which has high clinical evaluation value.
引文
[1]周丛乐,陈惠金,虞人杰.新生儿颅脑超声诊断学[M].北京:北京大学医学出版社,2007:112-113.
[2]李明明,朱梅.ASQ评价慢乙肝纤维化分期的研究[J].昆明医学院学报,2014,35(8):54-59.
[3]樊曦涌,周丛乐,王红梅,等.新生儿脑白质损伤的定量评价[J].临床儿科杂志,2008,26(3):178-182.
[2]李明明,朱梅.ASQ评价慢乙肝纤维化分期的研究[J].昆明医学院学报,2014,35(8):54-59.
[3]樊曦涌,周丛乐,王红梅,等.新生儿脑白质损伤的定量评价[J].临床儿科杂志,2008,26(3):178-182.