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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 investigate the brain development of infants with diabetic mothers. Methods The brain gray matter and white matter development of 64 diabetic mothers were evaluated by cranial ultrasound and medical image analysis software, and 101 non-diabetic mothers were used as controls. Combined with neonatal brain reactivity and neurodevelopment after neonatal period. Results The brain maturity of infants with diabetic mothers was poor. The average gray value of thalamic basal nuclei (76.92 ± 6.60), the mean gray value of frontal white matter (62.68 ± 5.21) and the average gray value of occipital lobe white matter (73.39 ± 5.67) compared with non-diabetic mothers [mean gray value of basal ganglia (84.72 ± 6.35), average gray value of frontal white matter (67.60 ± 4.09), mean gray value of occipital white matter (78.61 ± 2.95)], (P <0.01). Some of the ventricles were of different degree, 20 (31.25%) were in the ventricles of 64 infants with diabetic mothers, and the incidence of abnormalities in the uncontrolled mothers of the mothers (40%) was higher than that of the control group (23.5%). Neonatal brain reactivity test showed that the basal value of rSO2 (57.83 ± 3.34)%, the latency of rSO2 reaction (240.50 ± 16.69 s) and the rSO2 maximum response value (2.31 ± 0.84%, respectively, and the mothers with diabetes control group [(59.33 ± 4.56)%, (194.00 ± 25.03) s, (4.00 ± 2.24)%, respectively] and non-diabetic mothers infants [60.20 ± 4.15 ), (155.71 ± 16.23) s, (4.89 ± 1.47)%], the difference was statistically significant (P <0.01). After the newborn there are still varying degrees of brain maturity and poor neurological development. CONCLUSIONS: Pregnant mothers with diabetes mellitus may cause impaired brain maturation in offspring, which can be assessed by follow-up of neonatal brain gray matter, white matter development, early brain reactivity and neurodevelopment after neonatal period.