围产期窒息所致脑损伤、扩大的血管周围间隙数量与晚年睡眠质量之间的相关性
Correlation between perinatal asphyxia-induced brain injury, number of enlarged perivascular spaces, and sleep quality in later life.
摘要(中文译文)
围生期窒息（PA）越来越被认为是新生儿脑损伤的重要因素。寻找可靠的生物标志物来评估损伤严重程度至关重要。扩大的血管周围间隙（EPVSs）被认为是类淋巴功能障碍的影像学标志物，是疾病严重程度和预后的可靠指标。然而，EPVSs在新生儿中的应用尚不清楚。本研究旨在探讨EPVSs数量是否可作为PA所致脑损伤（PABI）严重程度及远期睡眠质量的新型生物标志物。将319例PA新生儿分为轻度组（n=229）和重度组（n=90）。收集临床、振幅整合脑电图（aEEG）和颅脑磁共振成像（MRI）数据。通过随访问卷评估睡眠质量。进行相关性分析以检验EPVSs数量与临床参数之间的关联。采用多因素线性回归分析评估EPVSs数量与PABI严重程度之间的独立相关性。同时评估EPVSs数量与婴儿远期睡眠质量之间的相关性。多个临床参数与EPVSs数量相关。单因素分析显示，生理状态、炎症标志物和EPVSs数量与PABI严重程度相关。多因素回归分析发现，EPVSs数量与PABI严重程度独立相关[所有婴儿（MRI）P=0.0001；轻度PA组（MRI）P=0.0248；重度PA组（MRI）P=0.0114]。在重度PA组中，EPVSs数量与远期睡眠质量显著相关（P=0.0061，r=0.3365），EPVSs数量越多与更严重的睡眠障碍相关。EPVSs数量可作为评估PA后脑损伤严重程度的新型影像学标志物；该标志物可预测远期睡眠障碍。总之，我们的数据表明类淋巴功能障碍可能参与窒息后脑损伤的发生。早期评估EPVSs有助于风险分层和干预策略的制定。
Abstract
Perinatal asphyxia (PA) is increasingly recognized as a significant contributor to neonatal brain injury. Identifying reliable biomarkers for assessing the severity of injury is crucial. Enlarged perivascular spaces (EPVSs), which are considered imaging markers of glymphatic dysfunction are reliable indicators of disease severity and prognosis. However, the application of EPVSs among neonates remains unclear. This study aims to investigate whether numbers of EPVSs can serve as a novel biomarker for the severity of PA-induced brain injury (PABI) and the sleep quality in later life. Neonates (n = 319) with PA were categorized as mild (n = 229) or severe (n = 90). Clinical, amplitude-integrated electroencephalography (aEEG), and cranial magnetic resonance imaging (MRI) data were collected. The sleep quality was assessed using questionnaires via follow-up. Correlation analysis was performed to examine associations between numbers of EPVSs and clinical parameters. Multivariate linear regression analysis was performed to evaluate the independent correlation between numbers of EPVSs and severity of PABI. The correlation between numbers of EPVSs and later sleep quality in infants was also evaluated. There were multiple clinical parameters correlated with numbers of EPVSs. Univariate analysis revealed that physiological status, inflammatory markers, and numbers of EPVSs were related with the severity of PABI. Multivariable regression analysis found that numbers of EPVSs independently related with the severity of PABI [P = 0.0001 in all infants (MRI); P = 0.0248 in mild PA group (MRI); P = 0.0114 in severe PA group (MRI)]. In the severe PA group, numbers of EPVSs were significantly correlated with long-term sleep quality (P = 0.0061, r = 0.3365), a higher number of EPVSs was associated with more severe sleep disturbance. Numbers of EPVSs may serve as a novel imaging biomarker for evaluating the severity of brain injury after PA; this biomarker can predict sleep disorders later in life. Collectively our data suggests that glymphatic dysfunction may contribute to post asphyxia-induced brain injury. Early evaluation of EPVSs could aid in risk stratification and intervention strategies.
如何引用
AMA
Xin-Yu Xue, Li Sun, Min Yu, Mei-Xia Li, Qiu-Yan Tian, Jing Ren, et al. Correlation between perinatal asphyxia-induced brain injury, number of enlarged perivascular spaces, and sleep quality in later life.. World journal of pediatrics : WJP. 2026; doi:10.1007/s12519-026-01093-8.
APA
Xin-Yu Xue, Li Sun, Min Yu, Mei-Xia Li, Qiu-Yan Tian, Jing Ren, et al (2026). Correlation between perinatal asphyxia-induced brain injury, number of enlarged perivascular spaces, and sleep quality in later life.. World journal of pediatrics : WJP. https://doi.org/10.1007/s12519-026-01093-8
GB/T 7714
Xin-Yu Xue, Li Sun, Min Yu, Mei-Xia Li, Qiu-Yan Tian, Jing Ren, et al. Correlation between perinatal asphyxia-induced brain injury, number of enlarged perivascular spaces, and sleep quality in later life.[J]. World journal of pediatrics : WJP, 2026 doi:10.1007/s12519-026-01093-8.
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