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目的 :通过预后探讨局部脑血流 (rCBF)断层显像分级诊断新生儿缺氧缺血性脑病 (HIE)的临床价值。方法 :对 32例HIE患儿行rCBF显像 ,根据放射性分布情况将显像结果分为 0、Ⅰ、Ⅱ、Ⅲ级 ;随访全部对照 3～ 6年 ,正常记 0分 ,有癫痫表现记 1分 ,智力低下记 2分 ,脑瘫记 3分 ;将各级得分进行比较。结果 :HIE并发症发生率为 2 5 % (8/ 32 ) ,Ⅲ级平均得分 (0 .5分 )明显高于 0 (0分 )、Ⅰ (0 .0 7分 )、Ⅱ (0 .5分 )级 (t=5 .89、10 .82、4 .2 7,P <0 .0 1) ,Ⅰ、Ⅱ级间差异有显著性 (t =2 .79,P <0 .0 5 )。结论 :rCBF显像能客观反映HIE的严重程度 ,有较高的预后预测价值 ,可作为临床分度诊断的标准之一。
Objective: To investigate the clinical value of regional cerebral blood flow (rCBF) imaging in the diagnosis of neonatal hypoxic-ischemic encephalopathy (HIE). Methods: 32 cases of HIE children underwent rCBF imaging, imaging results were divided into 0, Ⅰ, Ⅱ, Ⅲ grade according to the distribution of radioactivity; all the follow-up control of 3 to 6 years, normal score 0 points, with epilepsy recorded in mind 1 Points, mental retardation recorded 2 points, cerebral palsy recorded 3 points; the scores at all levels were compared. Results: The incidence of HIE complication was 25% (8/32), the average grade Ⅲ score (0.5 point) was significantly higher than 0 (0 point), Ⅰ (0.07 point), Ⅱ (0.5 (T = 5.89,10.82,4.27, P <0.01). There was significant difference between grade Ⅰ and Ⅱ (t = 2.79, P <0.05) . Conclusion: rCBF imaging can objectively reflect the severity of HIE and has a high predictive value of prognosis, which can be used as one of the criteria for clinical sub-diagnosis.