摘要
目的探讨糖尿病母亲婴儿脑发育情况。方法通过颅脑超声及应用医学图像分析软件对64例糖尿病母亲婴儿脑灰、白质发育的评价,101例非糖尿病母亲婴儿作对照。另配合新生儿脑反应性功能测定及新生儿期后神经发育的研究。结果糖尿病母亲婴儿脑成熟欠佳,足月糖尿病母亲婴儿丘脑基底核平均灰度值(76.92±6.60)、额叶白质平均灰度值(62.68±5.21)、枕叶白质平均灰度值(73.39±5.67)与非糖尿病母亲婴儿[丘脑基底核平均灰度值(84.72±6.35)、额叶白质平均灰度值(67.60±4.09)、枕叶白质平均灰度值(78.61±2.95)]比较,差异有显著性(P<0.01);部分不同程度脑室大,64例糖尿病母亲婴儿脑室大20例(31.25%),母亲糖尿病未控制组异常发生率(40%)高于控制组(23.5%)。新生儿脑反应性功能检测显示糖尿病母亲未控制组婴儿脑组织局部氧饱和度(rSO2)基础值(57.83±3.34)%、脑组织rSO2反应潜伏期(240.50±16.69s)、rSO2最大反应值(2.31±0.84)%,与母亲糖尿病控制组[分别为:(59.33±4.56)%、(194.00±25.03)s、(4.00±2·24)%]及非糖尿病母亲婴儿[分别为:(60.20±4.15)%、(155.71±16.23)s、(4.89±1.47)%]比较,差异有统计学意义(P<0.01)。新生儿期后仍存在不同程度的脑成熟度欠佳及神经发育落后。结论母亲孕期糖尿病可能造成子代脑成熟障碍,可通过对新生儿脑灰、白质发育,早期脑反应性功能及新生儿期后神经发育的随访予以评价。
Objective To study the brain development in infants of diabetic mother. Methods The development of cerebral grey matters and white matters was evaluated in 64 infants of pregnant diabetic mother by echoencephalography and medical image analysis system. The parameters were compared with 101 infants of non-diabetic mother. The early brain response function of newborns was assessed. The neurodevelopment after neonatal period was also evaluated. Results The brain in infants of diabetic mathers was immature. The average values of grey density in thalami （76.92 ±6. 60） were significantly lower in full term infants of diabetic mathers than that of the infants of non-diabetic mathers （84.72± 6.35）. These were also obvious in white matters of frontal lobe [（62.68±5.21） vs （67.60±4.09）] and occipital lobe [（73.39±5.67） vs （78.61±2.95）] （P〈0.01）. Partial infants of diabetic mathers appeared to have enlarged cerebral ventricles in different degree. Among the 64 infants, 20 had enlarged cerebral ventricles （31.25 %）. The infantile abnormal rate of un-controlled maternal diabetes （40%） was higher than that of control group （23.5%）. The measurement of early brain response function showed that the basic values of brain regional oxygen saturation （rSO2） （57.83±3.43） %, the response latency （240.50±16.69） s and the maximum response values of rSO2 （2.31±0.84） % in the group of un-controlled maternal diabetes were extremely different from that of control group （59.33±4.56） %, （194.0±25.03） s, （4.00±2.24）% and that of the infants of nondiabetic mathers （60.20±4.15）%, （155.71±16.23） s, （4.89±1.47）% （P〈0.01）. The brain immaturity and the neurodevelopment delay have still existed after neonatal period. Conclusions Maternal diabetes in pregnancy may result in filial generation brain immaturity. It can be evaluated by the development of cerebral grey matters and white matters, early brain response function of newborn, and the neurodevelopment after neonatal period.
出处
《中华围产医学杂志》
CAS
2005年第5期300-303,共4页
Chinese Journal of Perinatal Medicine
