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中华妇幼临床医学杂志(电子版) ›› 2007, Vol. 03 ›› Issue (05) : 246 -248. doi: 10.3877/cma.j.issn.1673-5250.2007.05.102

论著

早产儿脑室周围白质软化的相关因素
李晋辉, 伍金林, 李德渊, 熊英, 母得志   
  1. 四川大学华西第二医院儿科(四川成都,610041)
  • 出版日期:2007-10-01

Etiologic factors of the periventricular leukomalacia in preterm infants

Jin-hui LI, Jin-lin WU, De-yuan LI, Ying XIONG, De-zhi MU   

  1. West China Second University Hospital, Sichuan University, Chengdu 610041, China
  • Published:2007-10-01
引用本文:

李晋辉, 伍金林, 李德渊, 熊英, 母得志. 早产儿脑室周围白质软化的相关因素[J]. 中华妇幼临床医学杂志(电子版), 2007, 03(05): 246-248.

Jin-hui LI, Jin-lin WU, De-yuan LI, Ying XIONG, De-zhi MU. Etiologic factors of the periventricular leukomalacia in preterm infants[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2007, 03(05): 246-248.

目的

探讨早产儿脑室周围白质软化(periventricular leukomalacia, PVL)发病相关因素及临床特点。

方法

以2005年8月至2006年12月在本院住院的214例早产儿为研究对象,调查其胎龄、体重、出生情况,通过床旁颅脑彩超确诊PVL,记录PVL临床表现、彩超结果,并与同期入院无PVL早产儿进行比较。

结果

①胎龄与PVL发生有关(χ2=72.52,P<0.05);②出生体重与PVL发生有关(χ2=31.35,P<0.05);③重度窒息早产儿PVL发病率高,但Apgar评分与PVL发生无关(χ2=4.00,P>0.05);④PVL多在生后10 d内确诊,无明显临床表现。

结论

胎龄、出生体重与早产儿PVL的发生呈线性关系;Apgar评分高、低与早产儿PVL的发生并无明显关联;多数早产儿PVL无明显临床表现;床旁颅脑超声是早期诊断危重早产儿PVL的可靠、敏感和方便的手段。

Objective

To analyze the etiologic factors and clinical manifestation of the periventricular leukomalacia (PVL) in preterm infants.

Methods

214 preterm infants from August 2005 to December 2006 were accrued to investigate their gestational age, birth weight, birth history, and clinical symptoms. Cranial chromatic ultrasound was used to scan the preterm infants and diagnose PVL.

Results

①The incidence of PVL was associated with gestational age. The earlier the gestational age of infants, the higher the incidence of PVL occurred (χ2=72.52, P<0.05). ② The incidence of PVL was also associated with birth weight. The lower the birth weight of infants, the higher the incidence of PVL was observed(χ2=31.35, P<0.05). ③PVL occurred more frequently in infants with severe asphyxia than in those with mild asphyxia, but the incidence of PVL was not associated with Apgar score(χ2=4.00, P>0.05). ④PVL usually had mild clinical manifestations and was diagnosed within 10 days after birth.

Conclusions

Early gestational age, low birth weight were risk factors for PVL. Apgar score was not significantly associated with PVL. The clinical symptoms of PVL are usually mild in most patients. Cranial chromatic ultrasound is a reliable, sensitive and convenient method of early detection for PVL in critically ill preterm infants.

1 Larroque B, Marret S, Ancel PY, et al. White matter damage and intraventricular hemorrhage in very preterm infants: The EPIPAGE study. J Pediatr, 2003, 143(4): 477-483.
2 Volpe JJ. Neurobiology of periventricular leukomalacia in the preterm infant. Pediatr Neurol, 2001, 50(5): 553-562.
3 姚裕家. 早产儿脑损伤的病因及病理生理机制研究进展. 临床儿科杂志,2006, 24(3): 166-167.
4 Back SA, Han BH, Luo NL, et al. Selective vulnerability of late oligodendrocyte progenitors to hypoxia-ischemia. J Neurosci, 2002, 22(2): 455-463.
5 Kinney HC. Human myelination and perinatal white matter disorders. J Neurological Sci, 2005, 228(2):190-192.
6 Chew LJ, Takanohashi A, Bell M. Microglia and inflammation: Impact on developmental brain injuries. Ment Retard Dev Disabil Res Rev, 2006, 12(2):105-112.
7 Pierrat V, Duquennoy C, Van Haastert IC, et al. Ultrasound diagnosis and neurodevelopmental ourcome of localized extensive cystic periventricular leukomalacia. Arch Dis Child Fetal Neonatal Ed, 2001, 84(3):F151-156.
8 Mirmiran M, Barnes PD, Keller K, et al. Neonatal brain magnetic resonance imaging before discharge is better than serial cranial ultrasound in predicting cerebral palsy in very low birth weight preterm infants. Pediatrics, 2004, 114(4):992-998.
9 Counsell S, Allsop J, Harrison M, et al. Diffusion-weighted imaging of the brain in preterm infants with focal and diffuse white matter abnormality. Pediatrics, 2003, 112(1):176-180.
10 Berman J, Mukherjee P, Partridge JC, et al. Quantitative diffusion tensor MRI fiber tractography of sensorimotor development in premature infants. Neuroimage, 2005, 27(3):862-871.
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