从轻度缺氧缺血性脑病发展为中度缺氧缺血性脑病的婴儿的磁共振生物标志物和神经预后

IF 2.6 3区医学 Q1 PEDIATRICS

Neonatology Pub Date : 2023-01-01 DOI:10.1159/000527871

Paolo Montaldo, Simona Puzone, Elisabetta Caredda, Francesca Galdo, Umberto Pugliese, Anna Maietta, Serena Ascione, Mario Diplomatico, Ferdinando Spagnuolo, Vincenzina Roma, Massimiliano De Vivo, Mauro Carpentieri, Sabino Moschella, Lucio Giordano, Alessandra D'Amico, Carlo Capristo, Laura Travan, Giovanni Chello, Emanuele Miraglia Del Giudice, Mario Cirillo

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引用次数: 1

摘要

背景:越来越多的人担心，患有轻度缺氧缺血性脑病(HIE)的婴儿可能会发生癫痫发作，并在冷却治疗窗口后发展为中度HIE。目的:本研究的目的是研究治疗性低温对出生后24小时内患有轻度HIE和癫痫发作的婴儿的磁共振成像(MRI)生物标志物和神经学预后的影响。方法:本研究对366例(近)足月婴儿进行了观察性队列研究，这些婴儿患有轻度HIE，且振幅综合脑电图背景正常。结果:41例患儿出现进展(11.2%);29/41(70.7%)被冷却。在冷却组和非冷却组中，有进展的婴儿表现出脑代谢物紊乱和更高的白质损伤评分(p = 0.001, p = 0.02)。5/12(42%)未降温婴儿和7/29(24%)降温婴儿出现异常结局(p = 0.26)。结论:需要早期的生物标志物来识别有进展风险的轻度HIE婴儿。进展的轻度HIE婴儿表现出更高的脑损伤发生率和异常结局。

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Magnetic Resonance Biomarkers and Neurological Outcome of Infants with Mild Hypoxic-Ischaemic Encephalopathy Who Progress to Moderate Hypoxic-Ischaemic Encephalopathy.

Background: There is increasing concern that infants with mild hypoxic-ischaemic encephalopathy (HIE) may develop seizures and progress to moderate HIE beyond the therapeutic window for cooling.

Objective: The aim of this study was to examine the effect of therapeutic hypothermia on magnetic resonance imaging (MRI) biomarkers and neurological outcomes in infants with mild HIE and seizures within 24 h after birth.

Methods: This study shows an observational cohort study on 366 (near)-term infants with mild HIE and normal amplitude-integrated electroencephalography background.

Results: Forty-one infants showed progression (11.2%); 29/41 (70.7%) were cooled. Infants with progression showed cerebral metabolite perturbations and higher white matter injury scores compared to those without in both cooled and non-cooled groups (p = 0.001, p = 0.02). Abnormal outcomes were seen in 5/12 (42%) non-cooled and 7/29 (24%) cooled infants with progression (p = 0.26).

Conclusions: Early biomarkers are needed to identify infants with mild HIE at risk of progression. Mild HIE infants with progression showed a higher incidence of brain injury and abnormal outcomes.

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来源期刊

Neonatology 医学-小儿科

CiteScore

0.60

自引率

4.00%

发文量

审稿时长

6-12 weeks

期刊介绍： This highly respected and frequently cited journal is a prime source of information in the area of fetal and neonatal research. Original papers present research on all aspects of neonatology, fetal medicine and developmental biology. These papers encompass both basic science and clinical research including randomized trials, observational studies and epidemiology. Basic science research covers molecular biology, molecular genetics, physiology, biochemistry and pharmacology in fetal and neonatal life. In addition to the classic features the journal accepts papers for the sections Research Briefings and Sources of Neonatal Medicine (historical pieces). Papers reporting results of animal studies should be based upon hypotheses that relate to developmental processes or disorders in the human fetus or neonate.