新生儿胆红素脑病发病机制及磁共振诊断的研究进展
摘要
<正>新生儿黄疸是新生儿常见的临床现象之一,主要原因与新生儿红细胞寿命较短、血浆白蛋白不成熟、肝脏功能尚未发育完全、肠肝循环增加等有关,多属良性一过性表现,但也有少部分患儿发展成高胆红素血症,进一步形成急性胆红素脑病(acute bilirubin encephalopathy,ABE),甚至慢性胆红素脑病(chronic bilirubin encephalopathy,CBE),即核黄疸。
引文
[1]丁国芳,张苏平.我国部分地区正常新生儿黄疸的流行病学调查[J].中华儿科杂志,2 000, 38(1 0):624-627.
[2]Bertini G, Dani C, Tronchin M, Rubaltelli FF. Is breastfeeding really favoring early neonatal jaundice[J].Pediatrics,2001,107(3):E41.
[3]田丹丹.新生儿急性胆红素脑病发生的危险因素分析[J].罕少疾病杂志,2017, 24(1):11-12.
[4]符式新,张凯钟,柏燕.胆红素脑病患儿的MRI、MRS的影像特点及其临床转归[J].中国CT和MRI杂志,2 018,16(3):11-13.
[5]中华医学会儿科学分会新生儿学组.中国住院新生儿流行病学调查[J].中国当代儿科杂志,2009,11(1):15-20.
[6]Raplan M, Bromiker R,Hammerman C. Severe neonatal hyperbilirubinemia and kernicterus:are these still problems in the third millennium[J].Neonatology, 2011,100(4):354-362.
[7] Greco C,Arnolda G, Boo N-Y, Iskander IF,Okolo AA, Rohsiswatmo R,etal.Neonatal jaundice in Low-and middle-income countries:lessons and future directions from the 2015 don ostrow trieste yellow retreat[J]. Neo natology, 2016,110(3):172-180.
[8]中华医学会儿科学分会新生儿学组中国新生儿胆红素脑病研究协作组,Th eSubspecialtyGroupofNeonatology.中国新生儿胆红素脑病的多中心流行病学调查研究[J].中华儿科杂志,2012,50(5):331-335.
[9]葛佳静.足月及近足月新生儿胆红素脑病的临床分析[D]:浙江大学,2016.
[10]Ostrow JD,Pascolo L, Tiribelli C.Reassessment of the unbound concentrations of unconjugated bilirubin in relation to neurotoxicity in vitro[J]. Pediatric Research, 2003, 54(6):926.
[11]Brites D,Fernandes A,editors.Bilirubin-induced neural impairment:a special focus on myelination, age-related windows of susceptibility and associated comorbidities[J]. Seminars in Fetal and Neonatal Medicine, 2015, Elsevier.
[12]Dal Ben M,Bottin C, Zanconati F,Tiribelli C,Gazzin S. Evaluation of region selective bilirub ininduced brain damage as a basis for a pharmacological treatment[J].Scientific reports, 2017, 7:41032.
[13] Watchko JF,Tiribelli C. Bilirubininduced neurologic damage--mechanisms and management approaches[J]. New England Journal of Medicine,2013, 369(21):2021-2030.
[14]Gazzin S, Zelenka J, Zdrahalova L,et al.Bilirubin accumulation and Cyp mRNA expression in selected brain regions of jaundiced Gunn rat pups[J].Pediatric Research, 2012, 71(6):653-660.
[15]Gazzin S,Strazielle N, Schmitt C,et al.Differential expression of the multidrug resistancerelated proteins ABCbl and ABCcl between blood-brain interfaces[J].Journal of ComparativeNeurology,2008, 510(5):497-507.
[16] Falcao AS, Silva RF, Pancadas S,et al. Apoptosis and impairment of neurite network by short exposure of immature rat cortical neurons to unconjugated bilirubin increase with cell differentiation and are additionally enhanced by an inflammatory stimulus[J].Journal of Neuroscience Research, 2007, 85(6):1229.
[17]Brito MA,Lima S,Fernandes A, et al.Bilirubin injury to neurons:contribution of oxidative stress and rescue by glycoursodeoxycholic acid[J]. Neurotoxicology, 2008, 29(2):259-269.
[18]Fernandes A,Falcao AS,Abranches E,et al.Bilirubin as a determinant for altered neurogenesis, neuritogenesis,and synaptogenesis[J]. Developmental Neur obiology, 2009, 69(9):568-582.
[19]Brito MA,Vaz AR,Silva SL, et al.Nmethyl-D-aspar tate receptor and neuronal nitric oxide synthase activation mediate bilirubininduced neurotoxicity[J]. Molecular Medicine, 2010,16(9-10):372.
[20]Deganuto M,Cesaratto L,Bellarosa C,et al. A proteomic approach to the bilirubin-induced toxicity in neuronal cells reveals a protective function of DJ-1 protein[J]. Proteomi cs,2010,10(8):1645-1657.
[21]Boon AC,Hawkins CL,Coombes JS,Wagner KH, Bulmer AC. Bilirubin scavenges chloramines and inhibits myeloperoxidase-induced protein/lipid oxidation in physiologically relevant hyperbilirubinemic serum[J].2015, 86:259-268.
[22]Dora B. The Evolving Landscape of Neurotoxicity by Unconjugated Bilirubin:Role of Glial Cells and Inflammation[J]. Frontiers in Pharmacology,2012, 3(88):88.
[23] Silva SL, Vaz AR,Barateiro A, et al. Features of bilirubin-inducedreactive microglia:from phagocytosis to inflammation[J]. Neurobiology of disease, 2010, 40(3):663-675.
[24]Brites D,editor Bilirubin injury to neurons and glial cells:new players,novel targets, and newer insights[J]. Seminars in perinatology, 2011, Elsevier.
[25]Shapiro SM,editor Chronic bilirubin encephalopathy:diagnosis and outcome[J]. Seminars in Fetal and Neonatal Medicine, 2010, Elsevier.
[26]Palmela I, Sasaki H,Cardoso FL, et al.Time-dependent dual effects of high levels of unconjugated bilirubin on the human blood-brain barrier lining[J].Frontiers in cellular neuroscience, 2012, 6.
[27]Gazzin S,Berengeno AL, Strazielle N,et al.Modulation of Mrpl(ABCcl)and Pgp(ABCbl)by Bilirubin at the Blood-CSF and Blood-Brain Barriers in the Gunn Rat[J]. Plos One, 2011, 6(1):e16165.
[28]Stevenson D, Maisels MJ, Watchko J. Care of the Jaundiced Neonate[J].Medical, 2012.
[29]Turkel SB,Miller CA,Guttenberg ME, et al. A clinical pathologic reappraisal of kernicterus[J].Pediatrics,1982, 69(3):267-272.
[30]仪晓立,王晓颖,袁新宇,等.苍白球T1值诊断急性胆红素脑病[J].中国医学影像技术,2014, 30(5):645-648.
[31]Wang P,Zhang C-Z,Liu Y-C,et al. Demonstrating microstructural changes of basal ganglia in neonatal bilirubin encephalopathy with MP2RAGE[J]. Radiology of Infectious Diseases,2017, 4(4):164-169.
[32]易明岗.苍白球MR信号强度在诊断新生儿急性胆红素脑病的价值[D]:山东大学,2014.
[33] Zhang R,Bo T, Shen L,et al. SemiQuantitative Analysis of Brain MR Imaging in 76 Cases of Neonatal Indirect Hyperbilirubinemia[J]. Open Journal of Pediatrics, 2016, 6(4):280.
[34] Cece H,Abuhandan M,Cakmak A, et al.Diffusion-weighted imaging of patients with neonatal bilirubin encephalopathy[J].Japanese Journal of Radiology,2013, 31(3):179-185.
[35]Watchko JF,Painter MJ, Panigrahy A. Quantitative ADC in bilirubin encephalopathy[J].Japanese Journal of Radiology, 2013, 31(4):299-300.
[36] Wisnowski JL,Panigrahy A,Painter MJ, Watchko JF. Magnetic Resonance Imaging Abnormalities in Advanced Acute Bilirubin Encephalopathy Highlight Dentato-Thalamo-Cortical Pathways[J].J Pediatr,2016,174:260-263.
[37] Yan R, Han D, Ren J, et al. Application Values of Conventional MR I Combined with DTI in Neonatal Hyperbilirubinemia[J]. Pediatrics&Neonatology, 2017.
[38]任庆国,康笑水,郑金勇,等.MRI在新生儿胆红素脑病中的应用价值[J].山东大学学报(医学版),2010, 48(2):91-93.
[39] Wu W, Zhang P,Wang X, et al. Usefulness of 1H-MRS in differentiating bilirubin encephalopathy from severe hyperbilirubinemia in neonates[J].Journal of Magnetic Resonance Imaging, 2013, 38(3):634-640.
[40] Wang X,Wu W,Hou BL,e t al. Studying neonatal bilirubin encephalopathy with conventionalMRI, MRS,and DWI[J].Neuroradiology, 2008, 50(10):885-893.
[41]曹亚先,张雪林. MRI及^1H-MRS对新生儿苍白球胆红素损伤的监测价值[J].临床放射学杂志,2012, 31(1):107-111.
[42]Oakden WK,Moore AM,Blaser S, Noseworthy MD. 1H MR spectroscopic characteristics of kernicterus:a possible metabolic signature[J].American journal of neuroradiology, 2005, 26(6):1571-1574.
[43]Hu W, Cheng X, Ye X,et al.Ex vivo 1 H nuclear magnetic resonance spectroscopy reveals systematic alterations in cerebral metabolites as the key pathogenetic mechanism of bilirubin encephalapathy[J]. Molecular Bra in, 7,1(2014-11-26),2014,7(1):87.
[44]Zhang C-Z,Li Q,Wang P,Bian J,et al. Demonstrating Microstructural Environment of the Brain in Neonatal Bilirubin Encephalopathy with Diffusion Kurtosis Imaging[J]. Iranian Journal of Radiology, 2017,14(2):e44126.
[2]Bertini G, Dani C, Tronchin M, Rubaltelli FF. Is breastfeeding really favoring early neonatal jaundice[J].Pediatrics,2001,107(3):E41.
[3]田丹丹.新生儿急性胆红素脑病发生的危险因素分析[J].罕少疾病杂志,2017, 24(1):11-12.
[4]符式新,张凯钟,柏燕.胆红素脑病患儿的MRI、MRS的影像特点及其临床转归[J].中国CT和MRI杂志,2 018,16(3):11-13.
[5]中华医学会儿科学分会新生儿学组.中国住院新生儿流行病学调查[J].中国当代儿科杂志,2009,11(1):15-20.
[6]Raplan M, Bromiker R,Hammerman C. Severe neonatal hyperbilirubinemia and kernicterus:are these still problems in the third millennium[J].Neonatology, 2011,100(4):354-362.
[7] Greco C,Arnolda G, Boo N-Y, Iskander IF,Okolo AA, Rohsiswatmo R,etal.Neonatal jaundice in Low-and middle-income countries:lessons and future directions from the 2015 don ostrow trieste yellow retreat[J]. Neo natology, 2016,110(3):172-180.
[8]中华医学会儿科学分会新生儿学组中国新生儿胆红素脑病研究协作组,Th eSubspecialtyGroupofNeonatology.中国新生儿胆红素脑病的多中心流行病学调查研究[J].中华儿科杂志,2012,50(5):331-335.
[9]葛佳静.足月及近足月新生儿胆红素脑病的临床分析[D]:浙江大学,2016.
[10]Ostrow JD,Pascolo L, Tiribelli C.Reassessment of the unbound concentrations of unconjugated bilirubin in relation to neurotoxicity in vitro[J]. Pediatric Research, 2003, 54(6):926.
[11]Brites D,Fernandes A,editors.Bilirubin-induced neural impairment:a special focus on myelination, age-related windows of susceptibility and associated comorbidities[J]. Seminars in Fetal and Neonatal Medicine, 2015, Elsevier.
[12]Dal Ben M,Bottin C, Zanconati F,Tiribelli C,Gazzin S. Evaluation of region selective bilirub ininduced brain damage as a basis for a pharmacological treatment[J].Scientific reports, 2017, 7:41032.
[13] Watchko JF,Tiribelli C. Bilirubininduced neurologic damage--mechanisms and management approaches[J]. New England Journal of Medicine,2013, 369(21):2021-2030.
[14]Gazzin S, Zelenka J, Zdrahalova L,et al.Bilirubin accumulation and Cyp mRNA expression in selected brain regions of jaundiced Gunn rat pups[J].Pediatric Research, 2012, 71(6):653-660.
[15]Gazzin S,Strazielle N, Schmitt C,et al.Differential expression of the multidrug resistancerelated proteins ABCbl and ABCcl between blood-brain interfaces[J].Journal of ComparativeNeurology,2008, 510(5):497-507.
[16] Falcao AS, Silva RF, Pancadas S,et al. Apoptosis and impairment of neurite network by short exposure of immature rat cortical neurons to unconjugated bilirubin increase with cell differentiation and are additionally enhanced by an inflammatory stimulus[J].Journal of Neuroscience Research, 2007, 85(6):1229.
[17]Brito MA,Lima S,Fernandes A, et al.Bilirubin injury to neurons:contribution of oxidative stress and rescue by glycoursodeoxycholic acid[J]. Neurotoxicology, 2008, 29(2):259-269.
[18]Fernandes A,Falcao AS,Abranches E,et al.Bilirubin as a determinant for altered neurogenesis, neuritogenesis,and synaptogenesis[J]. Developmental Neur obiology, 2009, 69(9):568-582.
[19]Brito MA,Vaz AR,Silva SL, et al.Nmethyl-D-aspar tate receptor and neuronal nitric oxide synthase activation mediate bilirubininduced neurotoxicity[J]. Molecular Medicine, 2010,16(9-10):372.
[20]Deganuto M,Cesaratto L,Bellarosa C,et al. A proteomic approach to the bilirubin-induced toxicity in neuronal cells reveals a protective function of DJ-1 protein[J]. Proteomi cs,2010,10(8):1645-1657.
[21]Boon AC,Hawkins CL,Coombes JS,Wagner KH, Bulmer AC. Bilirubin scavenges chloramines and inhibits myeloperoxidase-induced protein/lipid oxidation in physiologically relevant hyperbilirubinemic serum[J].2015, 86:259-268.
[22]Dora B. The Evolving Landscape of Neurotoxicity by Unconjugated Bilirubin:Role of Glial Cells and Inflammation[J]. Frontiers in Pharmacology,2012, 3(88):88.
[23] Silva SL, Vaz AR,Barateiro A, et al. Features of bilirubin-inducedreactive microglia:from phagocytosis to inflammation[J]. Neurobiology of disease, 2010, 40(3):663-675.
[24]Brites D,editor Bilirubin injury to neurons and glial cells:new players,novel targets, and newer insights[J]. Seminars in perinatology, 2011, Elsevier.
[25]Shapiro SM,editor Chronic bilirubin encephalopathy:diagnosis and outcome[J]. Seminars in Fetal and Neonatal Medicine, 2010, Elsevier.
[26]Palmela I, Sasaki H,Cardoso FL, et al.Time-dependent dual effects of high levels of unconjugated bilirubin on the human blood-brain barrier lining[J].Frontiers in cellular neuroscience, 2012, 6.
[27]Gazzin S,Berengeno AL, Strazielle N,et al.Modulation of Mrpl(ABCcl)and Pgp(ABCbl)by Bilirubin at the Blood-CSF and Blood-Brain Barriers in the Gunn Rat[J]. Plos One, 2011, 6(1):e16165.
[28]Stevenson D, Maisels MJ, Watchko J. Care of the Jaundiced Neonate[J].Medical, 2012.
[29]Turkel SB,Miller CA,Guttenberg ME, et al. A clinical pathologic reappraisal of kernicterus[J].Pediatrics,1982, 69(3):267-272.
[30]仪晓立,王晓颖,袁新宇,等.苍白球T1值诊断急性胆红素脑病[J].中国医学影像技术,2014, 30(5):645-648.
[31]Wang P,Zhang C-Z,Liu Y-C,et al. Demonstrating microstructural changes of basal ganglia in neonatal bilirubin encephalopathy with MP2RAGE[J]. Radiology of Infectious Diseases,2017, 4(4):164-169.
[32]易明岗.苍白球MR信号强度在诊断新生儿急性胆红素脑病的价值[D]:山东大学,2014.
[33] Zhang R,Bo T, Shen L,et al. SemiQuantitative Analysis of Brain MR Imaging in 76 Cases of Neonatal Indirect Hyperbilirubinemia[J]. Open Journal of Pediatrics, 2016, 6(4):280.
[34] Cece H,Abuhandan M,Cakmak A, et al.Diffusion-weighted imaging of patients with neonatal bilirubin encephalopathy[J].Japanese Journal of Radiology,2013, 31(3):179-185.
[35]Watchko JF,Painter MJ, Panigrahy A. Quantitative ADC in bilirubin encephalopathy[J].Japanese Journal of Radiology, 2013, 31(4):299-300.
[36] Wisnowski JL,Panigrahy A,Painter MJ, Watchko JF. Magnetic Resonance Imaging Abnormalities in Advanced Acute Bilirubin Encephalopathy Highlight Dentato-Thalamo-Cortical Pathways[J].J Pediatr,2016,174:260-263.
[37] Yan R, Han D, Ren J, et al. Application Values of Conventional MR I Combined with DTI in Neonatal Hyperbilirubinemia[J]. Pediatrics&Neonatology, 2017.
[38]任庆国,康笑水,郑金勇,等.MRI在新生儿胆红素脑病中的应用价值[J].山东大学学报(医学版),2010, 48(2):91-93.
[39] Wu W, Zhang P,Wang X, et al. Usefulness of 1H-MRS in differentiating bilirubin encephalopathy from severe hyperbilirubinemia in neonates[J].Journal of Magnetic Resonance Imaging, 2013, 38(3):634-640.
[40] Wang X,Wu W,Hou BL,e t al. Studying neonatal bilirubin encephalopathy with conventionalMRI, MRS,and DWI[J].Neuroradiology, 2008, 50(10):885-893.
[41]曹亚先,张雪林. MRI及^1H-MRS对新生儿苍白球胆红素损伤的监测价值[J].临床放射学杂志,2012, 31(1):107-111.
[42]Oakden WK,Moore AM,Blaser S, Noseworthy MD. 1H MR spectroscopic characteristics of kernicterus:a possible metabolic signature[J].American journal of neuroradiology, 2005, 26(6):1571-1574.
[43]Hu W, Cheng X, Ye X,et al.Ex vivo 1 H nuclear magnetic resonance spectroscopy reveals systematic alterations in cerebral metabolites as the key pathogenetic mechanism of bilirubin encephalapathy[J]. Molecular Bra in, 7,1(2014-11-26),2014,7(1):87.
[44]Zhang C-Z,Li Q,Wang P,Bian J,et al. Demonstrating Microstructural Environment of the Brain in Neonatal Bilirubin Encephalopathy with Diffusion Kurtosis Imaging[J]. Iranian Journal of Radiology, 2017,14(2):e44126.
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