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Received:June 06, 2022 Published Online:March 20, 2023
Received:June 06, 2022 Published Online:March 20, 2023
中文摘要: 目的 探讨实时剪切波弹性成像(SWE)技术联合血清生物标志物[神经元特异性烯醇化酶(NSE)和S-100B蛋白]在早期诊断新生儿缺氧缺血性脑病(HIE)及预后预测中的价值。方法 收集2020年3月至2022年2月在西安市儿童医院收治的106例疑似HIE患儿,通过SWE检查后确诊为HIE的53例患儿为研究组,非HIE的53例患儿为对照组。比较两组SWE参数,大脑前动脉阻力指数(RI)、丘脑、小脑、大脑中动脉RI、血清生物标志物水平。研究上述指标与疾病严重程度的关系及SWE参数对HIE的诊断的意义。结果 与对照组相比,研究组患儿大脑前动脉RI、大脑中动脉RI水平上升,丘脑、小脑水平下降(P<0.01)。随着HIE严重程度的增加,大脑前动脉RI、大脑中动脉RI、NSE、S-100B表达水平上升,丘脑、小脑表达下降(P<0.01)。丘脑、小脑、NSE、S-100B表达与HIE严重程度呈正相关,大脑前动脉RI、大脑中动脉RI与HIE严重程度呈负相关(P<0.01)。与大脑前动脉RI、丘脑、小脑、大脑中动脉RI单项诊断相比,四项联合对HIE的诊断价值较强(P<0.01)。结论 SWE在HIE中具有重要的使用价值,并与血清生物标志物具有一定相关性,可用于对HIE情况变化及预后的预测。
中文关键词: 实时剪切波弹性成像 缺氧缺血性脑病,新生儿 神经元特异性烯醇化酶 S-100B蛋白 阻力指数
Abstract:Objective To explore the value of real-time shear-wave elastography (SWE) combined with serum biomarkers [neuron-specific enolase (NSE) and S-100B protein] in the early diagnosis of neonatal hypoxic-ischemic encephalopathy (HIE) and prognosis prediction. Methods A total of 106 children with suspected HIE admitted to Xi'an Children's Hospital from March 2020 to February 2022 were collected. Among them, 53 children diagnosed with HIE by real-time SWE were served as study group, and 53 children without HIE were served as control group. The levels of anterior cerebral artery resistance index (RI) , thalamus, cerebellum, middle cerebral artery RI, serum biomarkers and SWE parameters were compared between the two groups. The relationship between above indicators and disease severity, and the significance of SWE parameters for the diagnosis of HIE were studied. Results Compared with control group, the RI of the anterior cerebral artery and the middle cerebral artery in the study group increased, while the levels of thalamus and cerebellum decreased (P<0.01). With the increase of HIE severity, RI in anterior cerebral artery and the middle cerebral artery, the expression levels of NSE, S-100B increased, while RI in thalamus and cerebellum decreased (P<0.01). The thalamic RI, cerebellar RI, NSE, S-100B were positively correlated with the severity of HIE, while the anterior cerebral artery RI, middle cerebral artery RI were negatively correlated with the severity of HIE (P<0.01). Compared with the single diagnosis of anterior cerebral artery RI, thalamus, cerebellum and middle cerebral artery RI, the combination of the four items has a stronger diagnostic value for HIE (P<0.01). Conclusion SWE has important application value in HIE, and has certain correlation with serum biomarkers, which can be used for prediction of HIE changes and prognosis.
keywords: Real-time shear wave elastography Hypoxic-ischemic encephalopathy, neonatal Neuron-specific enolase S-100B protein Resistance index
文章编号: 中图分类号:R722.1 文献标志码:B
基金项目:西安市卫生健康委员会科研项目(2022yb24)
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