应用近红外光谱技术评价早产儿认知功能的探讨

目的：通过建立对早产儿光刺激后的反应模式,评价早产儿早期的认知功能,研究早产儿在发育过程中的脑反应性与足月儿之间的差距。方法：对纠正胎龄3个月、6个月的早产儿进行光刺激,应用近红外光谱技术,观察光刺激后脑反应性的变化,并与同龄儿对照。结果：早产儿在纠正胎龄3个月时,光刺激后开始反应时间、反应高峰出现的时间分别为17.2±5.2s、38.4±9.6s,明显长于足月儿的13.1±2.7s、28.9±5.0s;脑组织还原血红蛋白、氧合血红蛋白、脑组织氧饱和度在刺激后的最大反应值分别为(1.2±0.5)%、(1.5±0.6)%、(1.3±0.4)%,明显低于足月儿的(2.3±0.3)%、(2.8±0.3)%、(2.4±0.5)%。到了纠正胎龄6个月时,光刺激后的脑反应性与足月儿相比,无统计学差异。结论：早产儿在发育过程中,认知功能存在一定的滞后,到纠正胎龄3个月时,外界刺激后的脑反应性仍落后于同龄儿,到了纠正胎龄6个月时,脑反应性接近同龄儿,应加强对早产儿的早期干预。

Evaluation of early cognitive ability of infants born preterm by near-infrared spectroscopy

OBJECTIVE: To compare the differences in cerebral oxygenation responses between the infants born preterm and full-term infants and to evaluate the early cognitive ability of infants born preterm. METHODS: Cerebral oxygenation after light stimulation was detected by near infrared spectroscopy (NIRS) in preterm infants at 3 or 6 months corrected gestational age (GA). The results were compared with those of age-matched infants born at term. RESULTS: The start and peak response time of cerebral oxygenation occurring after light stimulation in preterm infants at 3 months corrected GA was 17.2 +/- 5.2 and 38.4 +/- 9.6 seconds respectively, which were significantly longer than in age-matched term infants (13.1 +/- 2.7 and 28.9 +/- 5.0 seconds respectively) (P < 0.05). The maximum response value of hemoglobin, oxyhemoglobin and regional oxygen saturation of the preterm infants at 3 months corrected GA was (1.2 +/- 0.5)%, (1.5 +/- 0.6)%, and (1.3 +/- 0.4)% respectively , which were significantly lower than that of the term infants [(2.3 +/- 0.3)%, (2.8 +/- 0.3)% and (2.4 +/- 0.5)% respectively] (P < 0.05). Cerebral oxygenation responses to light stimulation in preterm infants examined at 6 months corrected GA were not significantly different from age-matched term infants. CONCLUSIONS: Cerebral oxygenation responses to light stimulation in infants born preterm at 3 months corrected GA are not as good as age-matched term infants, but were close to the level of age-matched term infants at 6 months corrected GA. This suggests that the early cognitive ability of preterm infants before 3 months corrected GA might fall behind age-matched term infants.