The ratio of flow velocities in the middle cerebral and internal carotid arteries for the prediction of cerebral palsy in term neonates
The ratio of flow velocities in the middle cerebral and internal carotid arteries for the prediction of cerebral palsy in term neonates
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DOI：
10.7863/jum.2005.24.2.149
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发表时间：
2005-02-01
影响因子：
2.3
通讯作者：
Togari, H
中科院分区：
文献类型：
--
作者：
Fukuda, S;Kato, T;Togari, H
Objective.本研究评估了新生儿出生后第一天大脑中动脉（MCA）和颈内动脉（伊卡）的平均血流速度比值是否可用于识别未来的神经发育障碍。方法.我们观察了127例足月新生儿，无先天性畸形、染色体畸变、颅内出血或早发性败血症。从第1天到第3天，用多普勒流量计测量右侧和左侧ICA以及右侧和左侧MCA的平均脑血流速度。Vm比值定义为右侧和左侧MCA的平均速度/右侧和左侧ICA的平均速度。在12月龄时在门诊随访门诊进行神经系统检查以检测脑瘫（CP），并根据缺氧缺血性脑病（HIE）的诊断和神经系统预后将受试者分为4组：HIE-和正常神经功能组、HIE-和CP组、HIE+和正常神经功能组、HIE+和CP组。结果HIE合并CP组Vm比值显著低于HIE无CP组（P <0.05）。无CP的HIE+诊断与HIE+诊断和CP的新生儿之间的Vm比值无显著差异。结论. Vm比值可作为评估新生儿神经功能预后的一个有用指标，尤其是对未诊断为HIE的新生儿。
Objective. This study evaluated whether the ratio of the mean flow velocities in the middle cerebral artery (MCA) and the internal carotid artery (ICA) of neonates in the first days of life can be used to identify future neurodevelopmental disabilities. Methods. We observed 127 term neonates without congenital malformations, chromosomal aberrations, intracranial hemorrhage, or early onset sepsis. The mean cerebral blood flow velocities were measured in the right and left ICAs and in the right and left MCAs with a Doppler flowmeter once from day 1 to day 3. The Vm ratio was defined as the mean velocity in the right and left MCAs/mean velocity in the right and left ICAs. Neurologic examinations were performed at 12 months of age in the outpatient follow-up clinic to detect cerebral palsy (CP), and the subjects were divided into 4 groups according to the diagnosis of hypoxic-ischemic encephalopathy (HIE) and neurologic prognosis: HIE- and normal neurologic function, HIE- and CP, HIE+ and normal neurologic function, and HIE+ and CP. Results. The Vm ratio in infants with the HIE- diagnosis and CP was significantly lower than that in infants with the HIE- diagnosis without CP (P < .05). There was no significant difference between the Vm ratios in infants with the HIE+ diagnosis without CP and infants with the HIE+ diagnosis and CP. Conclusions. The Vm ratio might be a useful index in estimating neurologic outcome at birth, especially in neonates without the diagnosis of HIE.