【摘要】 目的　观察缺氧缺血性脑病 (HIE)的脑氧合代谢和脑血流量变化 ,早期判定不同程度缺氧缺血性脑病的脑功能状态。　方法　采用近红外光谱仪监测 2 4例 HIE患儿音乐刺激 (MS)前后脑前额皮质区域氧合血红蛋白 (Hb O2 ) ,还原血红蛋白 (Hb) ,总血红蛋白 (t Hb)的变化 ,并与对照组(30例 )作比较。　结果　对照组 Hb O2 、Hb、t Hb明显上升。HIE组 :轻度组 Hb O2 、t Hb变化差异无显著性 (P >0 .0 5 ) ,Hb明显增加 [MS前 :(- 0 .10± 0 .2 4)μmol/ L ,MS后 (0 .5 0± 0 .33)μmol/ L ,P<0 .0 5 ];中度组 Hb O2 、t Hb明显减少 [MS前 :(0 .0 7± 0 .44 )μmol/ L ,(0 .48± 0 .43)μmol/ L ,MS后 :(- 1.72± 0 .5 9)μmol/ L ,(- 0 .98± 0 .5 5 )μmol/ L ,P<0 .0 5 ],Hb明显增加 [MS前 :(0 .41± 0 .2 8)μm ol/ L ,MS后 :(0 .74± 0 .36μm ol/ L ,P<0 .0 5 ],重度组三项均降低 [MS前 :(0 .35± 0 .80 )μmol/ L ,(0 .2 2± 0 .47)μm ol/ L ,(0 .5 7± 0 .98)μmol/ L ,MS后 :(- 3.2 4± 1.37)μmol/ L ,(0 .15± 0 .5 1)μmol/ L ,(- 3.0 9± 1.39)μmol/ L ,P<0 .0 5 ]。将 HIE的病情程度与 MS前后 t Hb的变化差值进行直线相关分析 ,结果二者呈显著负相关关系 (r=- 0 .6 4,P<0 .0 0 1)。　结论　 NIRS可?更多还原

【Abstract】 Objective To investigate cerebral oxidative metabolism and changes of cerebral blood flow in hypoxic ischemic encephalopathy(HIE). To evaluate cerebral function of perinatal brain injury by monitoring of near infrared spectrophotometry (NIRS). Methods Oxyhemoglobin (HbO 2), deoxyhemoglobin(Hb) and total hemoglobin (tHb=HbO 2+Hb) in the brain were monitored by NIRS pre and post music stimulation (MS) on the frontal surface of brain in newborns, comparing with 34 cases of normal group. Results HbO 2, Hb tHb is remarkably increased after MS in normal group. HbO 2, tHb have no differences( P >0.05 ) and Hb were elevated significantly( P <0.05) in mild HIE patients; HbO 2, tHb were reduced [before MS:(0.07±0.44) μmol/L,(0.48±0.43)μmol/L, after MS:(-1.72±0.59)μmol/L,(-0.98±0.55)μmol/L, P <0.05]and Hb were elevated significantly( P <0.05)[before MS:(0.41±0.28)μmol/L, after MS:(0.74±0.36)μmol/L, P <0.05]in moderate HIE patients. HbO 2, Hb and tHb were reduced significantly in severe HIE patients[before MS:(0.35±0.80)μmol/L,(0.22±0.47)μmol/L,(0.57±0.98)μmol/L, after MS: (-3.24±1.37) μmol/L,(0.15±0.51)μmol/L,(-3.09±1.39)μmol/L, P <0.05]. There was a significant negative correlation between the severity of HIE and reducing amplitude of tHb (CBF) ( r=0.64, P <0.001) . Conclusions NIRS could detect Brain function of early hypoxic ischemic encepholopathy in newborns.更多还原