Physiological and pathological clinical conditions and light scattering in brain.
Physiological and pathological clinical conditions and light scattering in brain.
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DOI：
10.1038/srep31354
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发表时间：
2016-08-11
影响因子：
4.6
通讯作者：
Iwata O
中科院分区：
文献类型：
--
作者：
Kurata T;Iwata S;Tsuda K;Kinoshita M;Saikusa M;Hara N;Oda M;Ohmae E;Araki Y;Sugioka T;Takashima S;Iwata O
足月早产儿的MRI通常显示细微的脑损伤，如弥漫性白色物质损伤，这与后来的认知障碍有关。这种损伤的时间和机制尚不清楚。近红外光的约化散射系数（μ s '）已被证明与新生儿的胎龄线性相关。为了确定与脑μ s相关的临床变量，研究了60名出生后7天内的早产儿和足月儿。评估了从额头部获得的μs'对临床变量的依赖性。在单变量分析中，较小的μs'与产前糖皮质激素、紧急剖腹产、需要机械通气、胎龄较小、体型较小、1分钟和5分钟Apgar评分较低、脐带血pH和PO2较高以及研究时血HCO3−较高相关。多变量分析显示，较小的胎龄、需要机械通气和研究时较高的HCO3−与较小的μ s '相关。脑μs'取决于与脑的生理成熟和病理条件相关的变量。进一步的纵向研究可能有助于识别导致早产后轻微脑损伤和随后认知障碍的病理事件和临床状况。
MRI of preterm infants at term commonly reveals subtle brain lesions such as diffuse white matter injury, which are linked with later cognitive impairments. The timing and mechanism of such injury remains unclear. The reduced scattering coefficient of near-infrared light (μs’) has been shown to correlate linearly with gestational age in neonates. To identify clinical variables associated with brain μs’, 60 preterm and full-term infants were studied within 7 days of birth. Dependence of μs’ obtained from the frontal head on clinical variables was assessed. In the univariate analysis, smaller μs’ was associated with antenatal glucocorticoid, emergency Caesarean section, requirement for mechanical ventilation, smaller gestational age, smaller body sizes, low 1- and 5-minute Apgar scores, higher cord blood pH and PO2, and higher blood HCO3− at the time of study. Multivariate analysis revealed that smaller gestational age, requirement for mechanical ventilation, and higher HCO3− at the time of study were correlated with smaller μs’. Brain μs’ depended on variables associated with physiological maturation and pathological conditions of the brain. Further longitudinal studies may help identify pathological events and clinical conditions responsible for subtle brain injury and subsequent cognitive impairments following preterm birth.