高氧对胎鼠远端肺上皮细胞液体转运功能及上皮钠通道表达的影响

目的 探讨高氧对胎鼠远端肺上皮(FDLE)液体转运功能及上皮钠通道(ENaC)表达的影响.方法 分离提取大鼠FDLE细胞,随机分成高氧组和空气组,分别在氧浓度为85％和21％的细胞培养箱中原代培养.检测高氧暴露24h和48 h经FDLE细胞单层液体转运量的变化.应用Western blot方法检测高氧暴露后α-ENaC蛋白表达的变化.结果 高氧48h使大鼠FDLE液体转运增加(1.78±0.19 vs.1.06±0.11,P＜0.001),并且该促进作用可被阿米洛利抑制.高氧24h FDLE中α-ENaC蛋白表达与空气组比较差异无统计学意义(0.44 +0.04 vs.0.40±0.04,P=0.22),而高氧48h α-ENaC蛋白表达显著低于空气组(0.35±0.03 vs.0.47±0.06,P=0.03).结论 高氧增强了FDLE液体转运功能,且以阿米洛利敏感性液体转运增加为主.该促进作用并非通过增加α-ENaC蛋白表达来实现.     

Preoperative lung function in newborn infants with univentricular hearts compared with healthy controls

AIM: To measure the difference in lung function between newborns with univentricular hearts and healthy controls and study associations between lung function and pulmonary blood flow and pulmonary vasculature markings. METHOD: Tidal flow-volume measurements and single occlusion tests were performed before surgery on 25 unsedated spontaneously breathing newborns with univentricular hearts recruited over a 3-year period. Seventy-five healthy control infants were measured. Pulmonary blood flow was graded according to the haemodynamic effect of the echocardiographically defined anatomy of the heart defect. Pulmonary vasculature was graded according to radiological markings. RESULTS: The infants with univentricular hearts had a lower mean tidal volume of 4.7 ml (CI 2.3, 7.2, p < 0.001) (n = 24) and a lower mean compliance of the respiratory system of 12.7 ml/kPa (CI 4.6, 20.8, p = 0.004) (n = 14). Pulmonary blood flow grading was associated with respiratory rate (r = 0.53, p < 0.001), tidal volume (r =-0.48, p < 0.001), compliance (r =-0.55, p < 0.001) and resistance (r =-0.31, p = 0.043). Pulmonary vasculature grading was associated with compliance (r =-0.68, p = 0.006), resistance (r =-0.69, p = 0.007) and the time constant (r =-0.62, p = 0.042). CONCLUSION: Newborns with univentricular hearts have reduced tidal volumes and reduced compliance of the respiratory system. The lung function abnormalities are associated with the degree of pulmonary blood flow and pulmonary vasculature markings.     

Gastric emptying in very-low-birth-weight infants treated with nasal continuous positive airway pressure

OBJECTIVE: Nasal continuous positive airway pressure (NCPAP) is frequently used for prolonged periods in very low birth weight infants. We asked if NCPAP affects gastric emptying. STUDY DESIGN: Preterm newborn infants (n = 16) with a mean body weight of 935 g (SD, 155) and a mean gestational age of 27.7 weeks (SD, 1.9) were treated with NCPAP and fed by orogastric tube. A comparison group of 20 newborn infants with a mean body weight of 1090 grams (SD, 130) and a mean gestational age of 28.2 weeks (SD, 1.2) were not receiving NCPAP. All newborn infants received a milk formula containing 81 kcal/dL given in similar quantities. The antral cross-sectional area was measured by means of an ultrasound technique. RESULTS: Mean half-time of antral cross-sectional area was 28 minutes (SD, 12) in the NCPAP group and 40 minutes (SD, 17) in the comparison group ( P < .05). There were no differences in gastrointestinal complications between the two groups. CONCLUSIONS: The gastric emptying time was shorter for newborn infants treated with NCPAP.     

Hepatic microsomal drug oxidation and electron transport in newborn infants

Many drugs require oxidative metabolism for termination of action and/or for elimination from the body. Many oxidative reactions are catalyzed by hepatic microsomal enzymes. The activities of various drug-metabolizing enzymes, namely, NADPH cytochrome c reductase, NADPH oxidase, aminopyrine-N-demethylase, and analine P-hydroxylase, and the content of cytochrome P-450, were measured in hepatic microsomes obtained from seven newborn infants and four adult patients. The results in the newborn infant show increasing activities of these enzymes (except aminopyrine-N-demethylase) related to advancing age. Good correlation between three components of the hepatic microsomal mixed function oxidase system and aniline p-hydroxylase was established, whereas only NADPH oxidation correlated with aminopyrine N-demethylation. The rate of substrate or drug oxidation and the activities of the components of the microsomal electron transport pathway were lower than comparable values in the adult. The data demonstrate a possible biochemical basis for the transient deficiency in drug metabolism seen in newborn infants.     

Genetic and physiologic correlates of longitudinal immunoreactive trypsinogen decline in infants with cystic fibrosis identified through newborn screening

OBJECTIVES: To characterize the time course and physiologic significance of decline in serum immunoreactive trypsinogen (IRT) levels in infants with cystic fibrosis (CF) by mode of diagnosis and genotype, and to examine IRT heritability. STUDY DESIGN: We studied longitudinal IRT measurements in 317 children with CF. We developed statistical models to describe IRT decline. Pancreatic disease severity (Mild or Severe) was assigned using CF genotype and was confirmed in 47 infants through fat malabsorption studies. RESULTS: Infants with severe disease exhibited IRT decline with non-detectable levels typically seen by 5 years of age. Infants with mild disease exhibited a decline in the first 2 years, asymptomatically approaching a level greater than published norms. IRT and fecal fat were inversely correlated. IRT values in infants with meconium ileus (MI) were significantly lower than newborn-screened infants at birth. The high proportion of shared variation in predicted IRT values among sibling pairs with severe disease suggests that IRT is heritable. CONCLUSIONS: IRT declines characteristically in infants with CF. Lower IRT values in newborns with MI suggest increased pancreatic injury. Furthermore, IRT is heritable among patients with severe disease suggesting genetic modifiers of early CF pancreatic injury. This study demonstrates heritability of a statistically modeled quantitative phenotype.     

Oxygen saturation in healthy infants immediately after birth

OBJECTIVE: Because the optimal concentration of oxygen (FiO2) required for stabilization of the newly born infant has not been established, the FiO2 is commonly adjusted according to the infant's oxygen saturation (SpO2). We aimed to determine the range of pre-ductal SpO2 in the first minutes of life in healthy newborn infants. STUDY DESIGN: We applied an oximetry sensor to the infant's right palm or wrist of term and preterm deliveries immediately after birth. Infants who received any resuscitation or supplemental oxygen were excluded. SpO2 was recorded at 60 second intervals for at least 5 minutes and until the SpO2 was >90%. RESULTS: A total of 205 deliveries were monitored; 30 infants were excluded from the study. SpO2 readings were obtained within 60 seconds of age from 92 of 175 infants (53%). The median (interquartile range) SpO2 at 1 minute was 63% (53%-68%). There was a gradual rise in SpO2 with time, with a median SpO2 at 5 minutes of 90% (79%-91%). CONCLUSION: Many newborns have an SpO2 <90% during the first 5 minutes of life. This should be considered when choosing SpO2 targets for infants treated with supplemental oxygen in the delivery room.     

Differing lung function development in infants with univentricular hearts compared with healthy infants

Aim: To compare the difference in lung function development of healthy controls and patients with univentricular hearts from birth prior to surgery and during the first year of life when cardiac shunt procedures and the cavopulmonary connection are required. Methods: Tidal flow‐volume measurements and single‐occlusion tests were performed from birth serially up to 18 months of age on 28 unsedated spontaneously breathing infants with univentricular hearts and 58 healthy control infants. Results: Infants with univentricular heart physiology had low tidal volumes, low compliance of the respiratory system and high respiratory rate at birth, which over time normalized, whereas the peak expiratory flow increased during the study period. The lung function measured at birth was predictive of later lung function measurements. Conclusion: The pattern of lung function development is different in the patients with univentricular hearts compared to healthy controls. Lung function measured at birth is predictive of later lung function.     

哮喘气道重塑大鼠气道上皮细胞凋亡及布地奈德的干预作用

目的 1)研究哮喘气道重塑大鼠气道上皮细胞的凋亡情况 ；2)观察布地奈德对气道上皮细胞的凋亡和气道重塑的干预作用。材料和方法30只雄性SD大鼠随机分为正常对照组(C组)、哮喘重塑组(A组)、布地奈德治疗组(B组)，每组10只, A组给予致敏并激发12周,建立大鼠气道重塑模型。B组大鼠参照A组，只是激发半小时前，雾化吸入布地奈德1mg。C组大鼠参照A组，只是致敏激发时均用生理盐水代替。肺组织用于HE染色、Masson三色染色、PAS染色,观察气道周围炎症细胞浸润和气道结构改变。 结果 (1)光镜下发现A组明显的气道重塑的病理改变,B组A组较有所减轻(2)透射电镜观察均发现A组明显胶原沉积, B组A组较有所减轻。(3)图像分析结果(Image-Pro Plus 5.0):支气管壁厚度比较，A组 (110.01±13.77) 明显高于C组(77.25±7.56)(P<0.01)， B组(92.85±15.16)明显低于A组(P<0.05)，但高于C组(P<0.05)。平滑肌厚度比较，A组 (45.39±7.51) 明显高于C组(25.72±4.05)(P<0.01)，B组(36.48±4.70)明显低于A组 (P<0.05)，但高于C组(P<0.01)。各组大鼠肺组织胶原百分比比较：A组(12.79±3.75)明显高于C(3.16±0.90)(P<0.01),B组(9.09±1.46)明显低于A组(P<0.05)，但仍明显高于C组(P<0.01) (4) 图像分析免疫组化结果(Image-Pro Plus 5.0软件测阳性细胞数)： cleaved caspase-3阳性细胞数的比较，A组大气道上皮细胞和中小气道上皮细胞分别为[(10.49±2.82)，(9.58±1.86)] 明显高于C组 [(2.86±1.17),(2.44±1.0)](P均<0.01), B组分别为[(10.58±2.51)，(10.65±2.36)] 与A组(10.49±2.82)(9.58±1.86)比较无显著性差异(P均>0.05)，但明显高于C组 (P均<0.01)。结论: 1)哮喘气道重塑大鼠气道上皮细胞表达cleaved caspase－3显著增加，表明气道上皮凋亡在气道重塑组中明显增加。2)BUD不能抑制哮喘大鼠气道上皮细胞发生凋亡。3)布地奈德能部分抑制气道重塑。     

鼻塞式同步间歇指令通气和持续气道正压通气在早产儿呼吸窘迫综合征中的应用比较

目的：比较鼻塞式同步间歇指令通气(nSIMV)和鼻塞式持续气道正压通气（nCPAP）在早产儿呼吸窘迫综合征（RDS）中的临床应用效果。方法：50例RDS早产儿,常规使用肺表面活性物质进行替代治疗后,随机分入nSIMV组或nCPAP组,观察治疗后临床症状和血气指标的变化。结果：nSIMV组需气管插管行呼吸机通气比率明显低于nCPAP组（24% vs 60%, P<0.05）;nSIMV组CO2潴留和低氧血症的比率分别为12%和24%,明显低于nCPAP组的40%和36%（P<0.05）。结论：nSIMV能更有效地对RDS早产儿进行呼吸支持治疗。［中国当代儿科杂志,2010,12（7）：524-526］     

Structural airway abnormalities in infants and young children with cystic fibrosis

OBJECTIVES: To determine whether the airway structure of infants and young children with cystic fibrosis (CF) differs from that of normal children by using high-resolution computed tomography (HRCT) imaging. Study design Full-inflation, controlled ventilation HRCT images of the lungs were obtained at four anatomic levels in 34 infants with CF (age, 2.4+/-1.4 years) and 20 control infants (age, 1.8+/-1.4 years). Short axis diameters of all clearly identifiable, round airway/vessel pairs were measured to obtain airway wall thickness (AWT), airway lumen diameter (ALD), and vessel diameter (VD). RESULTS: In infants with CF, mean AWT (+/-SD) was 0.58+/-0.13 mm, ALD was 1.31+/-0.56 mm, and VD was 1.62+/-0.58 mm. In control infants, mean AWT was 0.49+/-0.13 mm, ALD was 1.07+/-0.42 mm, and VD was 1.86+/-0.64 mm. Mean AWT and ALD were greater in children with CF than in normal subjects (P<.001). ALD:VD ratios increased with age in patients with CF compared with control subjects (P=.026). CONCLUSIONS: The airways of infants and young children with CF have thicker walls and are more dilated than those of normal infants.     

Urodilatin excretion and its correlation with sodium excretion in healthy full-term newborn infants

BACKGROUND: Urodilatin (URO) is a member of the natriuretic family, cleaved by the kidney, which acts as a paracrine hormone in the regulation of natriuresis and diuresis. In newborn infants the excretion of urodilatin and its biological effects have not been explored. METHODS: We measured urinary URO excretion, by direct RIA (radioimmunoassay), as well as its correlation to neonatal body weight loss, and sodium homeostasis in 30 full-term newborn infants on the 4th day of life. RESULTS: The URO excretion, estimated as URO:creatinine ratio, was significantly correlated to sodium excretion. CONCLUSION: These data show that in full-term newborn infants the mechanisms that control synthesis, excretion and signal transduction of URO are developed and that URO contributes to natriuresis regulation.     

经鼻持续正压通气治疗新生儿肺透明膜病的评价

目的评价经鼻持续正压通气(NCPAP)与常规机械通气(CMV)对新生儿肺透明膜病(HMD)的治疗效果和NCPAP是否降低呼吸机相关肺炎(VAP),呼吸机所致肺损伤(VILI)等发生。方法 对38例在我院新生儿科住院的HMD患儿进行临床观察,随机分为两组,NCPAP组18例,CMV组20例。所有38例患儿均在生后24小时内给予单剂猪肺表面活性物质(固尔苏120 mg／kg)。NCPAP组应用INFANTFLOW SYSTEM(英国EME公司产)呼吸机。CMV组应用VIP BIRD(美国产)呼吸机IPPV+PEEP。辅助呼吸。结果 存活:NCPAP组16／18例,CMV组成活17／20例,两组在存活率、用机时间、颅内出血上无显著差异,而在呼吸机相关性肺炎、呼吸机致肺损伤并发症上,NCPAP组明显低于CMV组,经X2检验两组差异有显著,P<0.05。结论NCPAP可有效地治疗新生儿HMD,并可明显减少VAP和VILI的发生。     

不同正压通气方式联合肺表面活性物质在早产儿呼吸窘迫综合征中的应用

目的比较双水平气道正压通气( BiPAP) 和鼻塞式持续气道正压通气( NCPAP) 联合肺表面活性物质( PS) 在早产儿呼吸窘迫综合征( RDS) 中的应用效果。方法选择本科 2009年2月至 2012年2月收治的 80 例 RDS 早产儿,常规使用 PS 进行替代治疗后,随机分入 BiPAP 通气模式组( BiPAP 组) 和 NCPAP 通气模式组( NCPAP 组) ,每组各 40 例。观察两组工作参数、氧动力学指标、正压通气时间、氧疗时间、治疗成功率及气胸、支气管肺发育不良、早产儿视网膜病等并发症的发生率。结果 ( 1) 两组通气模式工作参数: 吸入氧浓度( FiO2) 、呼气末正压/呼气相正压( PEEP/EPAP) 均随通气时间延长逐渐降低,0 h( 上机时) 差异无统计学意义( P > 0. 05) ,上机后6 h、12 h、24 h、48 h BiPAP 组 FiO2、PEEP/EPAP 均低于 NCPAP 组,差异有统计学意义( P <0. 05 或0. 01) 。( 2) 两组均能保持较好的氧分压( PaO2) 、动脉血氧分压/吸入氧浓度比值( P/F) 、动脉/肺泡氧分压比值( PaO2/ PAO2) ,且均有上升趋势,二氧化碳分压( PaCO2) 呈降低趋势,两组在0 h 时各指标差异均无统计学意义( P >0. 05) ,BiPAP 组上机后 6 h、12 h、24 h、48 h PaO2、P/F、PaO2/ PAO2均明显高于 NCPAP 组( P <0. 05 或 0. 01) ,PaCO2低于 NCPAP 组( P <0. 05) 。( 3) BiPAP 组通气时间、氧疗时间明显短于 NCPAP 组,治疗成功率高于 NCPAP 组( P <0. 05) 。( 4) 两组气胸、支气管肺发育不良、早产儿视网膜病发生率差异无统计学意义( P >0. 05) 。结论 BiPAP 联合 PS 治疗 RDS早产儿的疗效优于 NCPAP,其具有高效、安全等优点,值得推广。     

Vestibular evoked myogenic potentials in term newborn infants with severe hyperbilirubinemia

Background: The aim of this study was to determine the effects of severe hyperbilirubinemia on vestibular evoked myogenic potentials (VEMP). Methods: A prospective study was designed. Seventeen term infants who suffered from severe hyperbilirubinemia in the first 5 postnatal days of age were included in the study group. The control group consisted of 17 healthy term infants. Audiological evaluation was performed, including tympanometry and transient evoked otoacoustic emissions, and VEMP tests. Results: All newborns passed audiological evaluation. Biphasic waveforms of VEMP were obtained in all of the 34 infants who had been tested. Both latencies of p13 and n23 were significantly delayed in the severe hyperbilirubinemia group (P < 0.05). Conclusion: This pilot is the first study to show that severe hyperbilirubinemia causes delay in VEMP latencies. We suggest that severe hyperbilirubinemia might affect the vestibular nuclei or the integrity of the inferior vestibular nerve and vestibulospinal tract. Further studies need to explain the relation between hyperbilirubinemia and the vestibular system.     

54例新生儿脑水肿血清渗透压临床监测研究

目的探讨脑水肿新生儿血清渗透压的变化规律及其在临床治疗中的指导作用。方法用微量渗透压仪（美国，Model3300）分别在入院当时、入院后第3、7天测定54例脑水肿新生儿及其电解质。以11例正常新生儿血清渗透压作为正常参考值。结果与正常新生儿血清渗透压相比，新生儿缺氧缺血性脑病（HIE）患儿第1、3天显著降低，第7天恢复正常；窒息新生儿第1、3天明显下降，第7天恢复正常：颅内出血新生儿的血清渗透压第1天显著增高，第3天明显增高，第7天恢复正常；呼吸窘迫伴重症肺炎新生儿渗透压第1、3天显著降低，第7天仍低于正常。结论不同病因引起新生儿脑水肿的血清渗透压下降程度及持续时间有所不同，窒息、HIE和呼吸窘迫伴重症肺炎患儿早期渗透压多有不同程度下降，同时存在低钠血症，颅内出血新生儿血清渗透压早期可增高。血清渗透压测定可有效帮助临床医师判断脑水肿新生儿病情变化及指导治疗。     

Electrical potential difference across the nasal epithelium is reduced in premature infants with chronic lung disease but is not associated with lower airway inflammation

Airway liquid content and insufficient absorptive airway ion transport at birth are potentially important factors in the development and severity of neonatal respiratory disease. The role of deficient absorptive airway ion transport in the development of chronic lung disease of prematurity is unknown. Additionally, lung inflammatory mediators modulate airway ion transport. Their effect on preterm lung ion transport and absorptive capacity is not established. We performed serial nasal potential difference studies and broncho-alveolar lavage in preterm infants born less than 30 wk postmenstrual age over the first four postnatal weeks. Our study aims were to: 1) compare nasal potential difference between preterm infants developing chronic lung disease and babies of similar gestation who do not; and 2) examine for an association between airway inflammation and ion transport parameters. We found that potential difference across the nasal epithelium increased with gestation, remained low and unchanged in infants developing chronic lung disease over the first four postnatal weeks, was significantly lower at four weeks in chronic lung disease infants, and was not associated with lower airway inflammation at any time point. We conclude that infants with chronic lung disease postnatally have a persistently reduced absorptive airway ion transport capacity.     

经鼻持续气道正压通气在极低出生体质量儿呼吸支持中的应用价值

目的 评价经鼻持续气道正压通气(nCPAP)在极低出生体质量儿呼吸支持中的应用价值.方法 我院NICU从1999年1月至2008年12月共收治155例机械通气治疗的极低出生体质量儿,前5年只用有创通气,后5年采用无创通气、有创通气相结合的治疗方法.比较应用nCPAP前后5年通气策略改变后的治疗情况,包括平均通气时间、治愈率及并发症.结果 前5年机械通气53例,均为有创通气,平均通气时间(6.16±4.84)d.后5年机械通气102例:单纯ncPAP通气60例;有创通气结合nCPAP通气20例(10例在nCPAP治疗过程中病情有加重趋势,及时转为气管插管有创通气,10例在有创通气后改为nCPAP);单纯有创通气22例.平均有创通气时间(3.93±2.48)d,与前5年比较有下降,但差异无显著性(t=1.37,P＞0.05).前5年治愈率为27/53(50.9%),放弃治疗20例(37.7%),死亡6例(11.3%).后5年治愈率为85/102(83.3%),与前5年比较有明显上升,差异有非常显著性(x~2=18.25,P＜0.01);放弃治疗13例(12.8%),死亡4例(3.9%).应用nCPAP后,呼吸机相关性肺炎发生率有显著下降(x~2=6.08,P＜0.01),肺气漏、颅内出血及慢性肺部疾病的发生率无明显变化.结论 nCPAP是治疗极低出生体质量儿的一种安全有效的方法,可以减少有创通气的应用,降低呼吸机相关性肺炎发生率.     

Circulating PCSK9 levels correlate with the serum LDL cholesterol level in newborn infants

Background and aims

Protein convertase subtilisin/Kexin type-9 (PCSK9) is a substantial player in lipoprotein metabolism. This study was designed to elucidate the role of PCSK9 in the regulation of lipoprotein during the fetal period.

Study design and subjects

This study was a cross-sectional study. Eighty-one neonates (45 males, 36 females) who were admitted to the neonatal intensive care unit were enrolled in the study. The median age in gestational weeks and weight at birth were 37.1 weeks and 2493 g, respectively. There were no gender differences, but the proportion of infants who were small-for-gestational age (SGA) was significantly higher among females than males. The prefed serum PCSK9 level was assayed with ELISA kits.

Results

The median PCSK9 concentration in male newborns was significantly lower than that in females (148.2 ng/ml vs. 171.4 ng/ml, respectively, p < 0.001). Circulating serum PCSK9 levels were positively correlated with total cholesterol (r = 0.281, p < 0.05) and low-density lipoprotein cholesterol (LDL-C; r = 0.272, p < 0.05). However, there were no correlations between PCSK9 levels and birth weight, gestational age or SGA. Multivariate forward stepwise linear regression analysis revealed that gestational age and circulating PCSK9 levels were independent predictors of the serum LDL-C levels in newborn infants.

Conclusion

Our first quantitative analysis of neonatal serum PCSK9 levels at birth showed that circulating PCSK9 levels show gender-based differences and are significantly correlated with LDL-C. These results suggest that PCSK9 could play an important role in regulating LDL-C levels during the fetal period.     

重度高胆红素血症新生儿苍白球磁共振成像特征及其临床意义

目的探讨苍白球MRI信号改变与高胆红素血症的严重程度及其相关因素关系,为胆红素脑病诊断与预后判定提供客观依据。方法36例高胆红素血症新生儿（TSB〉342μmoL／L）在生后[10±6（2～34）]d接受头部MRI检查。场强1．5～3．0Tesla,扫描序列为T1WI,T2WI和DWI。2名不知被检者病史的放射科医师分析MRI结果。结果首次MRI有20例苍白球T1WI呈对称性高信号。有苍白球信号改变组的TSB、B／A及UCB均显著高于无改变组[（605．28±89．19）μmoL／L vs．（438．19±67．89）μmoL／L,（1．08±0．18）vs．（0．77±0．16）,（555．49±92．3）μmoL／L vs．（412．01±54．8）μmoL／L,P=0．000],所有MRI-DWI均未见信号改变;TSB在342．0～427．5μmoL／L者9例,未见苍白球信号改变,427．5～513．0μmoL／L者7例,有改变者3例,超过525．0μmoL／L 20例,有改变者17例,黄疸程度与苍白球信号改变有密切关系（χ^2=15．000,P=0．000）;15例ABE苍白球T1WI均呈对称性的高信号（χ^2=17．601,P=0．000）,同时3例T2WI苍白球也呈对称性稍高信号（TSB分别为,745．3μmoL／L,735．7μmoL／L,707．6μmol/L）。7日内入院的25例中,16例苍白球有改变,平均入院时间显著晚于9例无改变者[（121．5±39．9）h vs．（68．9±35）h,P〈0．03]。6例接受了第2次MRI,其中3例ABE有2例苍白球信号转为T2WI高信号,临床均表现脑瘫,另1例苍白球信号正常,但有听力异常;余3例非ABE患儿,2例苍白球信号转为正常,1例两次均无苍白球信号异常,目前发育正常。结论MRI T1WI苍白球对称性高信号,与高胆红素血症的严重程度及暴露时间密切关系,是新生儿ABE的重要表现特征。T1WI高信号转变为T2WI高信号可能提示预后不良。