Early Glycemic Profile Is Associated with Brain Injury Patterns on Magnetic Resonance Imaging in Hypoxic Ischemic Encephalopathy.
Early Glycemic Profile Is Associated with Brain Injury Patterns on Magnetic Resonance Imaging in Hypoxic Ischemic Encephalopathy.
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DOI：
10.1016/j.jpeds.2018.07.041
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发表时间：
2018-12
期刊：
影响因子：
--
通讯作者：
Massaro AN
中科院分区：
文献类型：
--
作者：
Basu SK;Ottolini K;Govindan V;Mashat S;Vezina G;Wang Y;Ridore M;Chang T;Kaiser JR;Massaro AN
目的探讨新生儿缺氧缺血性脑病(HIE)早期血糖变化与磁共振成像(MRI)脑损伤类型的关系。我们对178名接受低体温治疗的新生儿进行了二次分析。血糖谱通过出生后24小时内的葡萄糖浓度确定：正常血糖(所有葡萄糖浓度为47至≤150 mg/dL；n=62)；低血糖(≥1浓度≤47 mg/dL；n=17)；高血糖(≥1浓度>；150 mg/dL；n=76)；以及不稳定血糖(低血糖和高血糖；n=23)。根据平均出生9天的复温后大脑磁共振成像的Barkovich评分，确定了151名婴儿的脑损伤类型。血糖值正常的婴儿中37/62(60%)的脑MRI正常，而血糖异常的婴儿中37/116(32%)的脑MRI正常(调整了脑病的Sarnat分期和5分钟的Apgar评分，P=0.02)。脑损伤的MRI图像在不同血糖水平组的分布不同(P=0.03)。与血糖正常的婴儿相比，低血糖(调整后的OR6；95%可信区间1.5-24.2)和不稳定血糖(6.6；1.6-27)的婴儿发生优势分水岭或局灶性多灶性损伤的几率更高。与血糖值正常的婴儿相比，血糖不稳定的婴儿有更高的优势基底节或全脑损伤的几率(5.6；1.1-29.3)。新生儿缺氧缺血性脑病的早期血糖谱与MRI上特定的脑损伤类型有关。需要进一步的研究来探索其作为表型生物标志物的预后意义和作用。
To investigate whether the early glycemic profile in infants with hypoxic ischemic encephalopathy (HIE) is associated with distinct brain injury patterns on magnetic resonance imaging (MRI). We performed a secondary analysis of 178 prospectively enrolled infants who received therapeutic hypothermia for HIE. Glycemic profiles were identified by glucose concentrations within 24 hours after birth: normoglycemia (all glucose concentrations >47 to ≤150 mg/dL; n=62); hypoglycemia (≥1 concentration ≤47 mg/dL; n=17), hyperglycemia (≥1 concentration >150 mg/dL; n=76), and labile glucose (both hypoglycemia and hyperglycemia; n=23). Patterns of brain injury were identified for 151 infants based on Barkovich scores from the post-rewarming brain MRIs on median age of 9 days. Normal brain MRI was reported in 37/62 (60%) infants with normal blood glucose values compared with 37/116 (32%) infants with an abnormal glucose profile (adjusted for Sarnat stage of encephalopathy and Apgar score at 5 minutes, P=.02). The distribution of MRI patterns of brain injury differed among the glycemic groups (P=.03). Odds of predominant watershed or focal-multifocal injury was higher in infants with hypoglycemia (adjusted OR 6; 95% CI 1.5–24.2) and labile glucose (6.6; 1.6–27) compared with infants with normoglycemia. Infants with labile glucose had higher odds (5.6; 1.1–29.3) of predominant basal ganglia or global injury compared with infants with normal blood glucose values. The early glycemic profile in infants with HIE is associated with specific patterns of brain injury on MRI. Further investigation is needed to explore its prognostic significance and role as a phenotype biomarker.
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DOI：
10.1056/nejmoa1112066
发表时间：
2012-05-31
期刊：
The New England journal of medicine
影响因子：
--
作者：
Shankaran S;Pappas A;McDonald SA;Vohr BR;Hintz SR;Yolton K;Gustafson KE;Leach TM;Green C;Bara R;Petrie Huitema CM;Ehrenkranz RA;Tyson JE;Das A;Hammond J;Peralta-Carcelen M;Evans PW;Heyne RJ;Wilson-Costello DE;Vaucher YE;Bauer CR;Dusick AM;Adams-Chapman I;Goldstein RF;Guillet R;Papile LA;Higgins RD;Eunice Kennedy Shriver NICHD Neonatal Research Network
通讯作者：
Eunice Kennedy Shriver NICHD Neonatal Research Network
影响因子：
168.9
作者：
Gluckman, PD;Wyatt, JS;Gunn, AJ
通讯作者：
Gunn, AJ
影响因子：
5.1
作者：
Miller, SP;Ramaswamy, V;Ferriero, DM
通讯作者：
Ferriero, DM
影响因子：
3.6
作者：
Li, Amanda M.;Chau, Vann;Miller, Steven P.
通讯作者：
Miller, Steven P.
DOI：
10.1136/archdischild-2016-311385
发表时间：
2017-07-01
影响因子：
4.4
作者：
Basu, Sudeepta K.;Salemi, Jason L.;Kaiser, Jeffrey R.
通讯作者：
Kaiser, Jeffrey R.