适于胎龄儿和小于胎龄儿小脑发育的对比研究

A comparative study of cerebellar development between appropriate-for-gestational age infants and small-for-gestational-age infants

摘要:

目的 探讨适于胎龄儿（AGA）和小于胎龄儿（SGA）的小脑发育是否存在差异。方法 选取165例胎龄25~40⁺⁶周的AGA和105例相应胎龄的SGA纳入研究。于新生儿出生24~48 h内采用超声测量小脑横径、小脑蚓部高度、小脑蚓部面积、小脑蚓部周长、小脑横径切面小脑面积、小脑横径切面小脑周长。采用Pearson相关分析法进行各测量值与胎龄关系的分析。结果 不论AGA还是SGA，小脑各测量值和胎龄均呈正相关（r=0.50~0.81，P < 0.05）。AGA和SGA各测量值在胎龄25~27⁺⁶周、28~30⁺⁶周、31~33⁺⁶周亚组中的比较差异无统计学意义（P > 0.05），但在胎龄34~36⁺⁶周、37~40⁺⁶周亚组中，SGA的各测量值均明显低于AGA（P < 0.05）。结论 胎龄 < 34周SGA的宫内小脑发育与同胎龄的AGA类似，而≥34周SGA的宫内小脑发育落后于AGA。

Abstract:

Objective To investigate whether there is a difference in cerebellar development between appropriate-for-gestational-age (AGA) infants and small-for-gestational-age (SGA) infants. Methods A total of 165 AGA infants and 105 SGA infants, with a gestational age of 26-40⁺⁶ weeks, were enrolled in this study. Within 24-48 hours after birth, ultrasound examination was performed to measure the transverse diameter of the cerebellum, the height of the vermis, the area of the vermis, the perimeter of the vermis, and the area and perimeter of the cerebellum on transverse section. A Pearson correlation analysis was used to investigate the correlation between cerebellar measurements and gestational age. Results In both AGA and SGA infants, all cerebellar measurements were positively correlated with gestational age (r=0.50-0.81, P < 0.05). In AGA and SGA infants, there were no significant differences in the measurements between the 25-27⁺⁶ weeks, 28-30⁺⁶ weeks, and 31-33⁺⁶ weeks of gestational age subgroups (P > 0.05), while in the 34-36⁺⁶ weeks and 37-40⁺⁶ weeks subgroups, the SGA infants had significantly lower measurements than the AGA infants (P < 0.05). Conclusions The SGA infants with a gestational age of <34 weeks have intrauterine cerebellar development similar to AGA infants, but those with a gestational age of ≥ 34 weeks have poorer intrauterine cerebellar development than AGA infants.