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Received:June 29, 2024 Published Online:May 20, 2025
Received:June 29, 2024 Published Online:May 20, 2025
中文摘要: 目的 探讨窒息早产儿出生早期有核红细胞（NRBC）变化对纠正年龄1岁之内神经系统预后评估的预测意义，为临床针对窒息早产儿脑保护策略的选择提供早期决策依据。方法 回顾性纳入2021年1月至2022年12月在河北大学附属医院新生儿科住院的窒息早产儿50例作为观察组，将20例无窒息的早产儿作为对照组。分别统计两组患儿出生后NRBC数据、头颅MRI及振幅整合脑电图检查结果，对两组患儿纠正42d及3、6、9、12月龄的发育商进行评估，并分析NRBC%与各时间点发育商的相关性。结果 观察组患儿出生后早期NRBC%高于对照组（P＜0.05）；观察组患儿振幅整合脑电图异常结果发生率高于对照组（P＜0.05）；观察组患儿头颅MRI异常影像发生率高于对照组（P＜0.05）；纠正42d和3、6、9、12月龄后观察组儿童发育行为评估量表评分均低于对照组（P＜0.05），且存在组间、时间点及组间和时间点交互效应（P＜0.05）。相关性分析显示NRBC与各纠正月龄段发育商评价结果间均呈负相关（P＜0.05）。结论 NRBC变化与窒息早产儿脑损伤程度密切相关，可作为预测窒息早产儿纠正1岁以内神经系统发育迟滞的早期判断指标，可为改善神经系统发育最终结局提早干预提供决策依据。
Abstract:Objective To explore the prognostic significance of nucleated red blood cell (NRBC) in asphyxiated premature infants within one year after birth, and to provide evidence for clinical decision of cerebral protection in asphyxiated premature infants. Methods Fifty asphyxiated premature infants hospitalized in the Department of Neonatology, Affiliated Hospital of Hebei University from January 2021 to December 2022 were enrolled as observation group and 20 non-asphyxiated premature infants as control group. NRBC data, brain MRI and amplitude-integrated electroencephalography were compared between the two groups. Developmental quotient (DQ) of two groups of children were evaluated after correction at 42 days and 3, 6, 9, and 12 months of age, and correlation between NRBC% and DQ at various time points was analyzed. Results The NRBC% in the early postnatal period of the observation group was higher than that of the control group (P＜0.05) . The incidence of abnormal amplitude-integrated electroencephalogram results in the observation group was higher than that of the control group (P＜0.05) . The incidence of abnormal cranial magnetic resonance imaging findings in the observation group was higher than that of the control group (P＜0.05) . After correction at 42 days, 3, 6, 9, and 12 months of age, the scores of the Developmental Behavior Checklist for children in the observation group were all lower than those in the control group (P＜0.05) . And there were time, inter group, and interactive effects (P＜0.05) . Scatter plots were drawn for the NRBC% of the observation group and the developmental quotient (DQ) of neurological assessments at different corrected ages. It was found that there was a negative correlation between NRBC and the DQ evaluation results at each corrected age (P＜0.05). Conclusion It can be used as an early index to predict the nervous system retardation in asphyxiated premature infants under corrected 1 year of age, and to provide a basis for early intervention to improve the outcome of the nervous system.
keywords: Nucleated erythrocytes Asphyxia Premature infants Nervous system development Cerebral injury Developmental quotient
文章编号： 中图分类号：R722 文献标志码：A
基金项目:保定市科技计划项目（2141ZF296）
| Author Name | Affiliation |
| JI Jinglu, LI Chaoying | Department of Pediatrics, Affiliated Hospital of Hebei University, Baoding, Hebei 071000, China |
| Author Name | Affiliation |
| JI Jinglu, LI Chaoying | Department of Pediatrics, Affiliated Hospital of Hebei University, Baoding, Hebei 071000, China |
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