中度高胆红素血症对婴儿大脑的影响：定量易感图和1H-MRS 研究

Effect of moderate hyperbilirubinemia on an infant's brain: a quantitative susceptibility mapping and¹H-MRS study

中度高胆红素血症对婴儿大脑的影响：定量易感图和¹H-MRS 研究

Authors: Ru Zhao, Jia-Jia Xu, Lian-Zi Su, Yan-Qi Shan, Hao Zhan, Qun Pei, Long-Sheng Wang, Li-Wei Zou

Source: Frontiers in Pediatrics

DOI: 10.3389/fped.2025.1464850

Abstract

Objective: The effects of moderate neonatal hyperbilirubinemia (NHB) remain unknown. The aim of this work was to investigate whether moderate NHB has an impact on an infant's brain and explore the relationship between brain magnetic susceptibility, brain metabolites, and biochemical tests in moderate NHB using quantitative susceptibility mapping (QSM) and magnetic resonance spectroscopy (MRS).

Materials and methods: In total, 28 term babies with moderate levels of blood bilirubin were enrolled in the NHB group, and 16 term infants were enrolled in the control group. All the patients underwent biochemical tests, ¹H-MRS, and QSM examinations. Biochemical test results [e.g., direct bilirubin (DBiL)], metabolite ratios [e.g., glycerophosphocholine (GPC)], and susceptibility values were collected. The Mann-Whitney U-test was used to assess the differences between the NHB and control groups. Partial least square correlation (PLSC) analyses were performed to analyze the correlations between the biochemical results and the metabolite ratios and susceptibility values.

Results: The Mann-Whitney U-test showed that significant differences were observed in the biochemical results, susceptibility values of the left putamen, and absolute concentrations of GPC between the NHB group and the controls. No significant differences were found in the metabolite ratios between the two groups. The PLSC analysis demonstrated that the ratios of myo-inositol (Ins), N-acetylaspartate (NAA), and GPC relative to creatine and phosphocreatine had a robust correlation with DBiL in the NHB group. Furthermore, increasing susceptibility values of putamen, globus pallidus, caudate nucleus, and thalamus had a moderate correlation with decreasing DBiL and increasing TSH concentrations in the NHB group.

Conclusion: This study demonstrated that moderate hyperbilirubinemia could induce metabolic and susceptibility changes in an infant's brain (e.g., decreased susceptibility values and metabolite values) and these changes have a correlation with biochemical test results.

Keywords: MRS; NHB; PLSC; QSM; TSB.

摘要

目的：新生儿中度高胆红素血症（NHB）的影响尚不清楚。本研究旨在利用定量易感图谱（QSM）和磁共振波谱（MRS）研究中度高胆红素血症是否会对婴儿大脑产生影响，并探讨中度高胆红素血症患者大脑磁感应强度、大脑代谢物和生化测试之间的关系。

材料和方法：NHB 组共纳入 28 名中度血胆红素水平的足月儿，对照组共纳入 16 名足月儿。所有患者均接受了生化检验、¹H-MRS 和 QSM 检查。收集了生化检验结果[如直接胆红素（DBiL）]、代谢物比率[如甘油磷酸胆碱（GPC）]和易感性值。采用 Mann-Whitney U 检验来评估 NHB 组和对照组之间的差异。进行偏最小二乘法相关性（PLSC）分析，以分析生化结果与代谢物比率和易感性值之间的相关性。

结果：Mann-Whitney U 检验表明，NHB 组与对照组之间在生化结果、左侧大脑丘脑的易感性值和 GPC 绝对浓度方面存在显著差异。两组之间的代谢物比率无明显差异。PLSC 分析表明，在 NHB 组中，肌醇（Ins）、N-乙酰天冬氨酸（NAA）和 GPC 相对于肌酸和磷酸肌酸的比率与 DBiL 有很强的相关性。此外，在 NHB 组中，普塔门、苍白球、尾状核和丘脑的易感性值的增加与 DBiL 的降低和 TSH 浓度的增加呈中度相关。

结论：本研究表明，中度高胆红素血症可诱发婴儿大脑的代谢和易感性变化（如易感性值和代谢物值下降），这些变化与生化检测结果相关。

关键词：磁共振波谱；新生儿高胆红素血症；偏最小二乘法相关性；定量易感图谱；血清总胆红素