诊断为缺氧缺血性脑病的新生儿血气参数随时间的改善程度与脑磁共振成像结果之间的关系

IF 1.3 Q3 PEDIATRICS Turkish archives of pediatrics Pub Date : 2024-11-01 DOI:10.5152/TurkArchPediatr.2024.24152
Aslan Yilmaz, Abdulkerim Uygur, Barıs Celik, Ali Metin Akdag, Demet Baser, Sureyya Ipek Ozturk
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摘要

研究目的在这项研究中,我们旨在评估婴儿出生后数小时内血气参数的改善程度与正常脑磁共振成像(MRI)和弥散收缩脑磁共振成像(MRI)之间的关系:本研究为回顾性队列研究。研究纳入了 2022 年 1 月至 2024 年 1 月期间在我科接受治疗性低温的缺氧缺血性脑病(HIE)诊断病例。病例档案中记录了临床表现、血气值(第一组,脐带;第二组,出生后第一小时;第三组,出生后第24小时)和核磁共振成像结果,并对正常组和弥散受限脑核磁共振成像组进行了比较:结果:在总共 19 个病例中,有 10 个病例被检测出脑核磁共振成像弥散受限。与正常磁共振成像组相比,弥散受限磁共振成像组的 5 分钟 Apgar 评分更低(P=0.038),机械呼吸机支持率更高(P=0.003)。弥散受限磁共振成像组的脐带血气中碱基过多(P=.022)、24 小时血气中 HCO₃过低(P=0.025)和抽搐(P=.033)之间存在关系。此外,研究还发现,与正常核磁共振成像组相比,只有弥散受限脑核磁共振成像组在第一小时的 pH 值改善水平显著(P=.025):结论:我们的研究表明,弥散受限脑磁共振成像与接受治疗性低温的HIE患者出生后最初几小时pH值的改善程度存在关系。
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The Relationship between the Improvement Level in Blood Gas Parameters in Time and Brain MRI Findings in Newborns with the Diagnosis of Hypoxic Ischemic Encephalopathy.

Objective: In this study, we aimed to evaluate the relationship between the level of improvement in blood gas parameters in the first hours of age and normal and diffusion-restriction brain magnetic resonance imaging (MRI).

Materials and methods: The study is a retrospective cohort study. Cases of the diagnosis of hypoxic-ischemic encephalopathy (HIE) who received therapeutic hypothermia in our unit between January 2022 and January 2024 were included in the study. Clinical findings, blood gas values (first, cord; second, first hours of age; third, 24th hour of age), and MRI results were recorded from the case files and compared between normal and diffusion-restricted brain MRI groups.

Results: Diffusion-restricted brain MRI was detected in 10 out of a total of 19 cases. The 5-minute Apgar score was lower (p=0.038) and mechanical ventilator support was higher (P=.003) in the diffusion-restricted MRI group than in the normal MRI group. The relationship was shown between high base excess (P=.022) in cord blood gas, low HCO₃ (p=0.025) in the 24th hour blood gas, and convulsion (P=.033) in the diffusion-restricted MRI group. Additionally, it was found that only the improvement level of the pH value in the first hour of age was significant (P=.025) in the diffusion-restricted brain MRI group than in the normal MRI group.

Conclusion: We showed that there was a relationship between diffusion-restricted brain MRI and the improvement level in the pH value in the first hours of age of patients diagnosed with HIE who received treatment for therapeutic hypothermia.

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