Relation between proton magnetic resonance spectroscopy within 18 hours of birth asphyxia and neurodevelopment at 1 year of age
Relation between proton magnetic resonance spectroscopy within 18 hours of birth asphyxia and neurodevelopment at 1 year of age
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DOI：
10.1017/s0012162299000171
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发表时间：
1999-02-01
影响因子：
3.8
通讯作者：
Edwards, AD
中科院分区：
文献类型：
--
作者：
Hanrahan, JD;Cox, IJ;Edwards, AD
该研究的目的是检验以下假设：疑似出生窒息后 18 小时内通过质子光谱检测到的脑乳酸升高与不良后果相关，并且乳酸升高可用于预测不良后果。 31 名疑似出生窒息的足月婴儿和 7 名对照婴儿在出生后 18 小时内使用三维化学位移成像进行了质子磁共振波谱检查。不良结果定义为 1 岁或以上死亡或神经发育障碍。九名婴儿出现不良后果。其他 22 名婴儿和所有对照婴儿均保持正常。异常组、正常组和对照组的中位（范围）乳酸/肌酸加磷酸肌酸（乳酸/肌酸）比率分别为1.14（0.17至3.81）、0.33（0至1.51）和0.05（0至0.6）（P=0.003）。乳酸/肌酸 >1.0 预测 1 岁时神经发育障碍，敏感性为 66%，特异性为 95%，阳性和阴性预测值分别为 86% 和 88%，似然比为 13.2。出生后 18 小时内脑乳酸/肌酸升高、窒息预示着不良后果。
The aim of the study was to test the hypotheses that elevated cerebral lactate, detected by proton spectroscopy performed within 18 hours of suspected birth asphyxia, is associated with adverse outcome, and that increased lactate can be used to predict adverse outcome. Thirty-one term infants suspected of having had birth asphyxia and seven control infants underwent proton magnetic resonance spectroscopy, using three-dimensional chemical shift imaging, within 18 hours of birth. Adverse outcome was defined as death or neurodevelopmental impairment at 1 year of age or more. Nine infants had an adverse outcome. The other 22 and all of the control infants remained normal. Median (range) lactate/creatine plus phosphocreatine (lactate/creatine) ratios in the abnormal, the normal, and the control group were 1.14 (0.17 to 3.81), 0.33 (0 to 1.51), and 0.05 (0 to 0.6) respectively (P=0.003). Lactate/creatine >1.0 predicted neurodevelopmental impairment at 1 year of age with sensitivity of 66% and specificity of 95%, positive and negative predictive values of 86% and 88%, and a likelihood ratio of 13.2. Elevated cerebral lactate/creatine within 18 hours of birth asphyxia predicts adverse outcome.