颅内出血新生儿的aEEG、MRI和血清MMP、TIMP的变化及临床意义

doi:10.7517/issn.1674-0475.220827

影像科学与光化学 ›› 2022, Vol. 40 ›› Issue (6): 1507-1512.DOI: 10.7517/issn.1674-0475.220827

颅内出血新生儿的aEEG、MRI和血清MMP、TIMP的变化及临床意义

闫永垒¹, 李文¹, 罗斌², 唐静¹, 任新悦¹, 付田丽¹, 赵静¹, 殷美乐¹, 陈丽祺¹

1. 承德市中心医院, 河北承德 067000;
2. 惠州市第二妇幼保健院(广东医科大学附属妇女儿童医院), 广东惠州 516000

收稿日期:2022-08-15 出版日期:2022-11-23 发布日期:2022-11-15
通讯作者: 陈丽祺
基金资助:
承德市科学技术研究与发展计划项目(202201A007)

Changes and Clinical Significance of aEEG, MRI, Serum MMP and TIMP in Neonates with Intracranial Hemorrhage

YAN Yonglei¹, LI Wen¹, LUO Bin², TANG Jing¹, REN Xinyue¹, FU Tianli¹, ZHAO Jing¹, YIN Meile¹, CHEN Liqi¹

1. Chengde Central Hospital, Chengde 067000, Hebei, P. R. China;
2. Huizhou Second Maternal and Child Health Hospital(Women and Children's Hospital Affiliated to Guangdong Medical University), Huizhou 516000, Guangdong, P. R. China

Received:2022-08-15 Online:2022-11-23 Published:2022-11-15

摘要/Abstract

摘要： 本研究探讨了颅内出血新生儿振幅整合脑电图(aEEG)、磁共振成像(MRI)的特征变化及血清基质金属蛋白酶9(MMP-9)、金属蛋白酶组织抑制剂-1(TIMP-1)水平的变化及其意义。选取确诊的63例颅内出血新生儿作为出血组,同期80例健康新生儿作为对照组。63例颅内出血新生儿,SWI检查方法对侧脑室出血的检出率(50.79%)高于MRI常规序列(33.33%)(P<0.05);出血组患儿的连续性电压中背景活动连续性患儿占比、睡眠-觉醒周期患儿占比均低于对照组患儿(P<0.05);出血组患儿的QS期下边界电压、AS期下边界电压测定值低于对照组,出血组患儿的QS期带宽、AS期带宽测定值均高于对照组(P<0.05)。出血组患儿的血清MMP-9、TIMP-1水平显著高于对照组(P<0.05);小出血量、中出血量、大出血量三组患儿的血清MMP-9、TIMP-1水平逐渐升高,组间比较差异有统计学意义(P<0.05)。颅内出血新生儿采用SWI检查能更准确地评估出血部位,aEEG对颅内出血具有较高的诊断价值,血清MMP-9、TIMP-1与颅内出血量有关,综合分析MRI、aEEG及血清MMP-9、TIMP-1水平变化有利于更好地临床诊断新生儿颅内出血情况。

关键词: 颅内出血, 振幅整合脑电图, 磁共振成像, 基质金属蛋白酶9, 金属蛋白酶组织抑制剂

Abstract: This study investigated the characteristic changes of amplitude-integrated electroencephalography (aEEG), magnetic resonance imaging (MRI) and serum levels of matrix metalloproteinase 9 (MMP-9) and tissue inhibitor of metalloproteinase (TIMP-1) in neonates with intracranial hemorrhage, and its meaning. A total of 63 neonates with confirmed intracranial hemorrhage were selected as the hemorrhage group, and 80 healthy neonates during the same period were selected as the control group. In 63 neonates with intracranial hemorrhage, the detection rate of contralateral ventricular hemorrhage by SWI (50.79%) was higher than that of conventional MRI sequence (33.33%) (P<0.05). The proportion of children with continuous background activity in the continuous voltage and the proportion of children with sleep-wake cycles in the bleeding group were lower than those in the control group (P<0.05). The measured values of the lower boundary voltage of the QS phase and the lower boundary voltage of the AS phase of the children in the hemorrhage group were lower than those of the control group, and the measured values of the QS phase bandwidth and the AS phase bandwidth of the children in the hemorrhage group were higher than those of the control group (P<0.05). The serum levels of MMP-9 and TIMP-1 in the hemorrhage group were significantly higher than those in the control group (P<0.05). The serum levels of MMP-9 and TIMP-1 in the mall bleeding volume group, the medium bleeding volume group, and the large bleeding volume group gradually increased (P<0.05),and the difference between the two groups was statistically significant (P<0.05). SWI examination in neonates with intracranial hemorrhage can more accurately assess the bleeding site. aEEG has high diagnostic value for intracranial hemorrhage. Serum MMP-9 and TIMP-1 are related to the amount of intracranial hemorrhage. Comprehensive analysis of MRI, aEEG and serum MMP-9 and TIMP-1 levels is conducive to better clinical diagnosis of neonatal intracranial hemorrhage.

Key words: intracranial hemorrhage, amplitude-integrated EEG, magnetic resonance imaging, matrix metalloproteinase 9, tissue inhibitor of metalloproteinase

闫永垒, 李文, 罗斌, 唐静, 任新悦, 付田丽, 赵静, 殷美乐, 陈丽祺. 颅内出血新生儿的aEEG、MRI和血清MMP、TIMP的变化及临床意义[J]. 影像科学与光化学, 2022, 40(6): 1507-1512.

YAN Yonglei, LI Wen, LUO Bin, TANG Jing, REN Xinyue, FU Tianli, ZHAO Jing, YIN Meile, CHEN Liqi. Changes and Clinical Significance of aEEG, MRI, Serum MMP and TIMP in Neonates with Intracranial Hemorrhage[J]. IMAGING SCIENCE AND PHOTOCHEMISTRY, 2022, 40(6): 1507-1512.

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颅内出血新生儿的aEEG、MRI和血清MMP、TIMP的变化及临床意义

Changes and Clinical Significance of aEEG, MRI, Serum MMP and TIMP in Neonates with Intracranial Hemorrhage

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