| Objective:①To determine neonatal brain changes of metabolites in neonatal hypoxic ischemic encephalopathy and the value of the condition and prognosis by means of the study of 3T-MRS②To determine cerebral metabolite changes of metabolites in premature newborns with hypoxic ischemic encephalopathy and the value of the condition and prognosis by means of the study of 3T-MRS.③To speculate their significance in brain injury outcome by means of strengthening the nutritional content of liquid milk and brain metabolites in preterm low birth weight.Methods:1. Will 40 cases with oxygen to the newborn ischemic brain full term basis of HIE clinical symptoms into mild, moderate or severe HIE HIE group, mild and moderate group of respectively for 18 cases, severely group 4 cases; The premature newborn oxygen ischemic encephalopathy of 22 patients; Another choice no brain injury in 6 cases term newborns for the control group. Among them, no brain injury newborns have bad group were history (such as:mild choking history; mild jaundice, but no diagnosis nuclear jaundice, encephalitis, etc.), but the clinical observation and do MRI brain injury after a newborn excluded, these babies are do regular MRI (T1WI, T2WI) and MRS analysis inspection. 2. Will all done MRI, MRS newborns in 6 months after birth follow-up CDCC do testing.3. The control group, mild HIE group, moderate, and severe HIE group of HIE group,46 cases in the hospital during the ordinary neonatal liquid formula fed, with ischemic brain premature oxygen group of brain injury premature low birthweight liquid formula fed.Result:1.For full-term babies of oxygen with ischemic brain, according to the level of MRS of clinical symptoms indexing, HIE degree between each group, a statistically significant difference compared (F=160.794, P=0.000); From low to high tier: severe HIE group (mean differences 350.50), moderate for HIE group (for 758.06), mild mean HIE group (for 930.89) group (mean); for 960.67 mean; each level difference were compared between groups, a statistically significant (P=0.000). MRS Cho level, according to the clinical symptoms, the HIBD group indexing between groups, difference degree compared with statistical significance (F=22.544, P=0.000); From low to high tier:group (mean differences 1049.667), mild group for 1150.44), mean for (HIE group (for moderate mean), severe 1196.11 HIE group (for 1361.00); mean Each level difference were compared between groups, a statistically significant (P=0.000). The Cr level, according to MRS clinical symptoms points degrees all HIE between groups of comparison, difference degree was not statistically significant (F=21.755, P=0.095); From low to high arrangement for:mild HIE group (for 718.22), moderate mean for 731.611 HIE group (mean), severe HIE group (mean differences 769.5) and control (for 788.50) for mean. The control group and the HIE group, MRS. Little sense level change computed radiography (Cr) MRS Lac level, according to the clinical symptoms points degrees all HIE group between groups, the difference degree compared with statistical significance (F=214.927, P= 0.000); From low to high tier:group (mean differences 86.33), mild for HIE group (for 255.94), moderate mean for 362.722 HIE group (mean), severe HIE group (for 818.25); mean Each level difference were compared between groups, a statistically significant (P=0.000).2. For MRS term newborns in ischemic brain of oxygen levels, basis, NAA/Cr clinical symptoms points degrees all HIE group between groups, the difference degree compared with statistical significance (F=100.310, P=0.000); From low to high tier:severe HIE group (mean differences 0.925), moderate for HIE group (for 1.083), mild mean HIE group (mean differences 1.286) and control (for 2.135); mean for Each level difference were compared between groups, a statistically significant (P =0.000). MRS Cho/Cr level, the clinical symptoms points degrees, according to the degree of HIE group between groups, difference compared with statistical significance (F=25.047, P=0.000); From low to high tier:group (mean differences 1.343), mild for HIE group (for 1.614), moderate mean for 1.698 HIE group (mean), severe HIE group (for 1.933); mean Each level difference were compared between groups, a statistically significant (P=0.000). MRS NAA/Cho level, the based on clinical symptoms indexing, each HIE group between groups, the difference degree compared with statistical significance (F=214.720, P=0.000); from low to high tier: severe HIE group (mean differences 0.358), moderate for HIE group (for 0.635), mild mean HIE group (for 0.807), controls mean for 1.013). (mean differences MRS Cho/NAA level, the clinical symptoms points degrees, according to the degree of HIE group between groups, difference compared with statistical significance (F=272.155, P=0.000); From low to high tier:HIE group (for comparison 1.093), mild mean HIE group (for 1.236), moderate mean for 1.606 HIE group (mean), severe HIE group (for 2.935); mean Each level difference were compared between groups, a statistically significant (P=0.000). The Lac/NAA MRS olumes level, according to clinical symptoms points degrees all HIE group between groups, difference degree compared with statistical significance (F=577.604, P=0.000); Each level difference were compared between groups, a statistically significant (P=0.000). MRS Lac/Cr level, the clinical symptoms points degrees, according to the degree of HIE group between groups, difference compared with statistical significance (F=73.880, P=0.000); From low to high tier:HIE group (for comparison 0.195), mild mean HIE group (mean differences 0.424), moderate for mean HIE group, (severe for 0.71),group (mean differences(1.02); Each level difference were compared between groups, a statistically significant (P=0.000).3. Premature oxygen for MRS with ischemic encephalopathy in level, NAA comparison, differences between the two groups are statistically significant (F= 20.312, P=0.000); From low to high arrangement with oxygen for:premature for ischemic encephalopathy group (mean differences 20.312) and control (for 960.67 mean); The comparison between the two groups are statistically significant difference (P=0.000). MRS of Cho level, the comparison between the two groups, the differences are statistically significant (F=2.788, P=0.000); From low to high tier: group (mean differences with 1049.667), premature for oxygen for ischemic encephalopathy group (mean differences 1356.00); MRS of Cr level, the two differences between groups, compared with statistical significance (F=-1.013, P= 0.000); From low to high arrangement with oxygen for:control (788.50), andpremature for ischemic encephalopathy group (mean differences 793.00) this mean for comparison, the difference Cr no chang. MRS of Lac,the level, this compared between the two groups, a statistically significant difference (F=-5.232, P =0.000); From low to high tier:group (mean differences with 86.33), premature for ischemic encephalopathy group oxygen (f mean differences with of 229.55, this mean compared between the two groups are statistically significant difference (P= 0.000).4. Premature oxygen for MRS with ischemic encephalopathy in level, NAA/Cr comparison, differences between the two groups are statistically significant (F= 9.833, P=0.000); from low to high arrangement with oxygen for:premature for ischemic encephalopathy group (mean differences 1.130) and control (for 2.135 mean); The comparison between the two groups are statistically significant difference (P=0.000). MRS of Cho/Cr level, the comparison between the two groups, the differences are statistically significant (F=1.666, P=0.000); From low to high tier: group (mean differences with 1.343), premature for oxygen for ischemic encephalopathy group (mean differences 2.083); MRS of Cho level, the two/differences between groups, compared with statistical significance (F=1.013, P =0.000); From low to high arrangement with oxygen for:premature for ischemic encephalopathy group (mean differences 0.755) and control (1.013), this mean for comparison, the difference between the two groups are statistically significant (P= 0.000). MRS of Cho/NAA level, this compared between the two groups, a statistically significant difference (F=-12.659, P=0.000); from low to high tier: group (mean differences with 1.093), premature for ischemic encephalopathy group (oxygen for 2.331), this mean compared between the two groups are statistically significant difference (P=0.000). The Lac/MRS level, the difference between the two groups, compared with statistical significance (F=-14.033, P=0.000); From low to high tier:group (mean differences with 0.090), premature for oxygen for ischemic encephalopathy group (mean differences 0.675), the comparison between the two groups are statistically significant difference (P=0.000). MRS Lac/Cr level, the comparison between the two groups, the differences are statistically significant (F =-6.165, P=0.000); from low to high tier:group (mean differences with 0.195), premature for oxygen for ischemic encephalopathy group (mean differences 0.688), the comparison between the two groups are statistically significant difference (P= 0.000).Conclusion:1. In the control group, NAA, Cr, Cho peak towering of MRS can be displayed, Lac peak is low-lying or not, a descending order of the peak is Cho, NAA, Cr, Lac; the change of NAA peak height are related with the degree of brain damage in children with HIE. the NAA peak MRS is no significant decrease in mild HIE group, in the moderate HIE group the peakof NAA is further reduce, Lac peak height is significantly lower in the most severe HIE group. The change of NAA peak height are related with the degree of brain damage in children with HIE. The severer the degree of brain damage in children with HIE,the highe Lac peak height i, in the mild HIE group, the Lac peak height is lower, in moderate HIE group, Lac peak is not obvious and it increased most in severe HIE group.2. All the index measured in MRS indicate clearly:Cho, Lac, Cho/Cr, Cho/ NAA, Cr/NAA are rising with the aggravation of HIE; The NAA, NAA/Cho, NAA /Cr were negatively correlated with the HIE; as the reference wave MRS,Cr value has changed little.3.. After birth, the more HIE severe clinical symptoms, the worse the prognosis in children; the higher elevated Lac peak height in MRS,and the longer its height continued the severer the hypoxic ischemic encephalopathy in children; In addition, the lower of NAA peak height of MRS, the more Chances of poor prognosis in children; the longer of NAA peak height decline, the worse prognosis in children. |
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