早产儿脑室周围-脑室内出血与小脑发育的相关研究

doi:10.13418/j.issn.1001-165x.2021.06.007

中国临床解剖学杂志 ›› 2021, Vol. 39 ›› Issue (6): 654-659.doi: 10.13418/j.issn.1001-165x.2021.06.007

早产儿脑室周围-脑室内出血与小脑发育的相关研究

刘瑞可，　李桂芳，　王影，　杜学谦

沧州市人民医院，河北沧州 061000

收稿日期:2020-07-07 出版日期:2021-11-25 发布日期:2021-12-01
通讯作者: 李桂芳，教授，研究生导师，Tel:(0317)5297067，E-mail:990505232@qq.com
作者简介:刘瑞可（1982-），女，河北沧州人，副主任医师，硕士，主要从事新生儿疾病方面的研究，E-mail:liuruike @msn.com
基金资助:
2020年度河北省医学科学研究课题计划（20200173）

Study on the relationship between periventricular-intraventricular hemorrhages and cerebellar development in preterm infants

Liu Ruike, Li Guifang, Wang Ying, Du Xueqian

Cangzhou People’s Hospital, Cangzhou 061000, Hebei Province, China

Received:2020-07-07 Online:2021-11-25 Published:2021-12-01

摘要/Abstract

摘要： 目的　利用颅脑超声技术评估PIVH对VLBW早产儿小脑生长发育的影响。方法　选取200例胎龄25~31+6周VLBW早产儿，分为有PIVH组67例，无PIVH组133例，比较两组早产儿体重、头围、小脑横径、蚓部高度、前后径、周长和面积的差异。结果　纠正胎龄至足月时，有PIVH的早产儿小脑横径、蚓部高度、前后径、周长和面积均低于无PIVH的早产儿（P<0.05），体重（P=0.31）和头围（P=0.462）无显著性差异；亚组分析中，Ⅲ、Ⅳ度PIVH早产儿的小脑横径低于Ⅰ、Ⅱ度PIVH早产儿（P=0.012），体重、头围、小脑蚓部高度、前后径、周长和面积均无显著性差异。结论 PIVH可能对VLBW早产儿小脑生长发育有显著影响，特别是PIVH严重的早产儿，小脑横径比其他指标受影响更大。

关键词: 小脑, 　超声, 　早产儿, 　脑室周围-脑室内出血

Abstract: Objective　To assess the effect of PIVH on the cerebellar development in VLBW premature infants by means of cranial ultrasound.　Methods　Two hundred VLBW premature infants with gestational age 25 to 31+6 weeks were enrolled and divided into with a PIVH group (n=67), and a without PIVH group (n=133). The differences in transverse cerebellar diameter, vermis height, vermis diameter, vermis circumference and vermis area between the two groups were compared.　Results　Transverse cerebellar diameter, vermis height, vermis diameter, vermis circumference and vermis area of preterm infants in the PIVH group were significantly lower than those of preterm ones in the without PIVH group at term equivalent age (P<0.05). There was no significant difference in weight (P=0.31) and head circumference (P=0.462). In subgroup analysis, Transverse cerebellar diameter of the preterm infants with grades Ⅲ、Ⅳ PIVH was significantly lower than those of preterm ones with grades Ⅰ、Ⅱ PIVH (P=0.012). There were no significant difference in weight, head circumference, vermis height, vermis diameter, vermis circumference and vermis between these subgroups.　Conclusions　PIVH may have a significant impact on cerebellar development in VLBW premature infants, especially those with a severe PIVH. The transverse cerebellar diameter is more affected than other indicators.

Key words: Cerebellum, 　Cranial ultrasound, 　Premature infant, Periventricular-intraventricular hemorrhages

中图分类号:

R722.19

刘瑞可, 李桂芳, 王影, 杜学谦. 早产儿脑室周围-脑室内出血与小脑发育的相关研究[J]. 中国临床解剖学杂志, 2021, 39(6): 654-659.

参考文献 20

[1]	Ortinaul C, Neil J. The neuroanatomy of prematurity: normal brain development and the impact of preterm birth[J]. Clin Anat, 2015, 28(2):168-183. DOI: 10.1002/ca.22430.
[2]	Mazouri A, Massahi M, Khalesi N, et al. Investigation of the relationship between umbilical cord pH and intraventricular hemorrhage of infants delivered preterm[J]. Rev Assoc Med Bras, 2019, 65(5):647-656. DOI: 10.1590/1806-9282.65.5.647.
[3]	Gano D, Barkovich AJ. Cerebellar hypoplasia of prematurity: Causes and consequences[J]. Handb Clin Neurol, 2019, 162:201-216. DOI: 10.1016/B978-0-444-64029-1.00009-6.
[4]	Adre J, du Plessis, Limperopoulos C, et al. Chapter 4-Cerebellar Development[M]. Volpes Neurology of the Newborn, 2018:73-99.
[5]	Tam EW, Ferriero DM, Xu D, et al. Cerebellar development in the preterm neonate: effect of supratentorial brain injury[J]. Pediatr Res, 2009, 66(1):102-106. 2018, 142(5): DOI: 10.1203/PDR. 0b013e 3181a 1fb3d.
[6]	刘瑞可, 孙洁, 胡丽燕, 等. 早产儿胼胝体生长率与智力运动发育的相关性研究[J]. 中国当代儿科杂志, 2015(08):84-89. DOI: 10.7499/j.issn.1008-8830.2015.08.016.
[7]	Limperopoulos C, Soul JS, Gauvreau K, et al. Late gestation cerebellar growth is rapid and impeded by premature birth[J]. Pediatrics. 2005, 115(3):688-695. DOI: 10.1542/peds.2004-1169.
[8]	Srinivasan L, Allsop J, Counsell SJ, et al. Smaller cerebellar volumes in very preterm infants at term-equivalent age are associated with the presence of supratentorial lesions[J]. AJNR Am J Neuroradiol, 2006, 27(3):573-579.
[9]	Selim S, Gursoy T, Karatekin G, et al. Effect of intraventricular hemorrhage on cerebellar growth in preterm neonates[J]. Cerebellum, 2017, 16(1): 89-94. DOI: 10.1007/s12311-016-0766-0.
[10]	Vople JJ. Neurology of the Newborn: 5th ed. Saunders, Philadelphia, 2008:541.
[11]	邵肖梅, 叶鸿瑁, 丘小灿. 实用新生儿学[M]. 第5版. 北京：人民卫生出版社, 2019: 855.
[12]	Beckinghausen J, Sillitoe RV. Insights into cerebellar development and connectivity[J]. Neurosci Lett, 2019, 688: 2-13. DOI: 10.1016/j.neulet.2018.05.013.
[13]	Adamaszek M, DAgata F, Ferrucci R, et al. Consensus paper: cerebellum and emotion[J]. Cerebellum, 2017,16(2):552-576. DOI: 10.1007/s12311-016-0815-8.
[14]	Baumann O, Borra R J, Bower J M, et al. Consensus paper: the role of the cerebellum in perceptual processes[J]. Cerebellum, 2015, 14(2):197-220. DOI: 10.1007/s12311-014-0627-7.
[15]	丁文龙, 刘学政. 系统解剖学[M]. 第9版. 北京：人民卫生出版社, 2018:358.
[16]	Allin MPG, Salaria S, Nosarti C, et al. Vermis and lateral lobes of the cerebellum in adolescents born very preterm[J]. Neuro Report, 2005, 16(16):1821-1824. DOI: 10.1097/01.wnr.0000185014.36939.84.
[17]	Brossard-Racine M, Du Plessis AJ, Limperopoulos C. Developmental cerebellar cognitive affective syndrome in ex-preterm survivors following cerebellar injury[J]. Cerebellum, 2015, 14(2):151-164. DOI: 10.1007/s12311-014-0597-9.
[18]	Iskusnykh IY, Buddington RK, Chizhikov VV. Preterm birth disrupts cerebellar development by affecting granule cell proliferation program and Bergmann glia[J]. Exp Neurol, 2018, 306:209-221. DOI: 10.1016/j.expneurol.2018.05.015.
[19]	Corrales JD, Rocco GL, Blaess S, et al. Spatial pattern of sonic hedgehog signaling through Gli genes during cerebellum development[J]. Development, 2004, 131:5581-5590. DOI: 10.1242/dev.01438.
[20]	Sathyanesan A, Zhou J, Scafidi J, et al. Emerging connections between cerebellar development, behaviour and complex brain disorders[J]. Nat Rev Neurosci, 2019, 20(5): 298-313. DOI: 10.1038/s41583-019-0152-2.

早产儿脑室周围-脑室内出血与小脑发育的相关研究

Study on the relationship between periventricular-intraventricular hemorrhages and cerebellar development in preterm infants

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