摘要
目的 分析多模态磁共振成像(MRI)、胶原纤维酸性蛋白(GFAP)及B淋巴细胞瘤-2蛋白(Bcl-2)诊断新生儿缺氧缺血性脑病(HIE)的价值。方法 选取2021年2月—2022年1月在绍兴第二医院医共体总院诊治的64例HIE患儿为观察组,同期出生无脑损伤的30例新生儿为对照组。两组均给予常规MRI扫描、扩散加权成像(DWI)及动脉自旋标记灌注成像(ASL)扫描,采用反射免疫分析法检测Bcl-2水平,采用酶联免疫吸附法检测GFAP水平。分析多模态MRI参数、GFAP、Bcl-2水平与病情严重程度之间的相关性,分析多模态MRI参数、GFAP、Bcl-2对HIE的诊断价值。结果 对照组T_(1)、表观弥散系数(ADC)、脑血流量(CBF)分别为(1 163.25±57.81)ms、(2.07±0.48)×10^(-3)mm~2/s、(16.36±1.23)ml/(100 g·min),观察组T_(1)、ADC、CBF分别为(1 432.96±64.82)ms、(1.19±0.10)×10^(-3)mm~2/s、(27.08±2.94)ml/(100 g·min)。与对照组相比,观察组T_(1)、CBF升高,ADC降低,差异均有统计学意义(均P<0.05)。轻度、中度、重度HIE患儿T_(1)、CBF、ADC、GFAP、Bcl-2水平比较,差异均有统计学意义(均P<0.05)。HIE患儿T_(1)、CBF、GFAP、Bcl-2与疾病严重程度均呈正相关(r=0.476,0.473,0.512,0.464,均P<0.05);ADC与疾病严重程度呈负相关(r=-0.483,P<0.05)。T_(1)与GFAP、Bcl-2均呈正相关(r=0.442、0.436,均P<0.05);ADC与GFAP、Bcl-2均呈负相关(r=-0.479、-0.525,均P<0.05);CBF与GFAP、Bcl-2均呈正相关(r=0.497、0.513,均P<0.05)。与多模态MRI、GFAP、Bcl-2单独检测相比,联合检测诊断HIE的灵敏度最高。结论 多模态MRI、GFAP、Bcl-2水平与HIE患儿病情严重程度密切相关,三者联合检测可有效提高HIE的临床诊断准确性。
Objective To analyze the value of multimodal MRI,glial fibrillary acidic protein(GFAP),and B-lymphocytic carcinoma-2(Bcl-2) in diagnosis of neonatal hypoxic-ischemic encephalopathy(HIE).Methods From February 2021 to January 2022,64 neonates with HIE diagnosed and treated in General Hospital of Medical Community,Shaoxing Second Hospital were selected as observation group,and 30 neonates without brain injury were selected as control group.All the neonates in the two groups underwent conventional MRI scanning,diffusion-weighted imaging(DWI),and arterial spin-labeled perfusion imaging(ASL) scanning.Reflex immunoassay was used to detect Bcl-2 levels,enzyme-linked immunosorbent assay was used to detect GFAP levels.The correlations between multimodal MRI parameters,GFAP,Bcl-2 levels and severity of the disease were analyzed,and the value of multimodal MRI parameters,GFAP,and Bcl-2 in diagnosis of HIE was analyzed.Results T_1,apparent diffusion coefficient(ADC),and cerebral blood flow(CBF) in control group were(1 163.25±57.81) ms,(2.07±0.48)×10~(-3)mm~2/s,and(16.36±1.23) ml/(100 g·min),respectively,T_1,ADC,and CBF in observation group were(1 432.96±64.82) ms,(1.19±0.10)×10~(-3)mm~2/s,and(27.08±2.94)ml/(100 g·min),respectively.Compared with control group,T_(1) and CBF increased and ADC decreased in observation group,there were statistically significant differences(P<0.05).There were statistically significant differences in T_1,CBF,ADC,GFAP,and Bcl-2 levels among mild,moderate,ans severe HIE neonates(P<0.05).In HIE neonates,T_1,CBF,GFAP,and Bcl-2 were positively correlated with severity of HIE(r=0.476,0.473,0.512,0.464,P<0.05),ADC was negatively correlated with severity of HIE(r=-0.483,P<0.05).T_(1) was positively correlated with GFAP and Bcl-2(r=0.442,0.436,P<0.05);ADC was negatively correlated with GFAP and Bcl-2(r=-0.479,-0.525,P<0.05);CBF was positively correlated with GFAP and Bcl-2(r=0.497,0.513,P<0.05).Compared with single detection of multimodal MRI,GFAP,and Bcl-2,the sensitivity of joint detection in diagnosis of HIE was the highest.Conclusion Multimodal MRI,GFAP,and Bcl-2 levels are closely correlated with severity of HIE neonates,joint detection can effectively improve clinical diagnostic accuracy of neonatal HIE.
作者
朱秀益
徐宏伟
俞金娜
王海滨
ZHU Xiu-yi;XU Hong-wei;YU Jin-na;WANG Hai-bin(General Hospital of Medical Community,Shaoxing Second Hospital,Shaoxing,Zhejiang 312000,China)
出处
《中国妇幼保健》
CAS
2023年第23期4721-4724,共4页
Maternal and Child Health Care of China
基金
浙江省卫生健康科技计划项目(2021RC102)。
关键词
多模态磁共振成像
B淋巴细胞瘤-2蛋白
胶原纤维酸性蛋白
新生儿缺氧缺血性脑病
Multimodal magnetic resonance imaging
B-lymphocytic carcinoma-2
Collagen-fibrous acidic protein
Neonatal nypoxic-ischemic encepnalopatny
