新生儿缺氧缺血性脑病的DWI表现及ADC值与血清NSE的相关性研究

目的:观察新生儿缺血缺氧性脑病(hypoxic ischemic encephalopathy,HIE)病变脑区的DWI表现,并检测其ADC值及血清神经元特异性烯醇化酶(NSE)水平,探讨ADC值与NSE水平的相关性,为HIE的早期诊断和治疗提供依据。方法:收集足月新生儿HIE 27例,随机选取30例健康新生儿作为对照组。均在出生后24~48h检测血清NSE,1周内行MRI检查,均测量脑区的ADC值,对比HIE患儿与对照组的ADC值,并进行病变脑区ADC值与血清NSE的相关性分析。结果:①HIE患儿病变脑区的ADC值明显低于正常新生儿脑组织的ADC值(P0.05),轻、中度HIE患儿病变组织的ADC值差异无统计学意义(P0.05),重度患儿病变组织的ADC值低于轻度和中度患儿(P0.05)。②重度HIE患儿的血清NSE值大于轻度和中度患儿,中度HIE患儿的血清NSE值大于轻度患儿(P0.05)。③重度HIE患儿DWI上高信号的病灶数多于轻度和中度患儿,中度HIE患儿DWI上高信号的病灶数多于轻度(P0.05)。结论:HIE患儿病变脑区的ADC值低于与正常对照组,且与血清NSE水平呈负相关,二者联合可为足月新生儿HIE的早期诊断和治疗提供理论依据。

Changes of DWI and serum NSE level,and their correlation in neonates with hypoxia-ischemic encephalopathy

Objective：To observe the expression of the brain lesions in diffusion weighted imaging ,detect the changes of ADC values and serum NSE levels ,and explore the correlation of the ADC values and NSE levels in hypoxia-ischemic encephalopathy newborn patients ,thus provide the new theory basis for the diagnosis and treatment of HIE .Methods：27 HIE patients of full term were collected .The serum NSE levels were tested in 24~48 h and MRI was examined in one week .The correlation be-tween the ADC values and the NSE level were analyzed .30 healthy babies were selected randomly as control group .Results：The ADC values of the HIE patients were significantly lower than that of the normal neonates （P〈0 .05） .There existed no differ-ence in the ADC values of mild and moderate HIE patients （P〉0 .05） .The ADC values of severe babies were lower than those of the mild and moderate HIE patients （P〈0 .05） .The NSE levels of severe HIE patients were higher than that of mild and moderate .The NSE levels of moderate HIE patients were higher than that of the mild HIE patient （P〈0 .05） .The number of high signal of DWI image in the severe HIE patients were more than that of mild and moderate HIE patients .The number of high signal areas of DWI image in moderate HIE patients were more than that of mild HIE patients （P〈0 .05） .Conclusions ：The ADC values decrease in the brain lesions of HIE patients and it is negatively correlated with the serum NSE level ,and the expression of DWI combined with the NSE Levels provide a new theory basis for the early diagnosis and treatment of HIE patients .