Influence of nimodipine on cerebral hemodynamics indices and brain parenchyma density in neonates with hypoxic-ischemic encephalopathy

Abstract

Objective To explore the changes of cerebral hemodynamics indices and brain parenchyma density in neonates with hypoxic-ischemic encephalopathy ( HIE ) and the role of intervention with nimodipine.Methods 58 neonates with moderate and severe HIE were randomly divided into two groups including routine (n = 28)and nimodipine( n = 30 ), with 20 healthy full-term neonates as controls. Based on the routine treatment, nimodipine was given intravenously in the nimodipine group for 10 ～ 14 days. The hemodynamics indices included peak systolic flow velocity(PSFV) , end-diastolic flow velocity( EDFV), mean blood flow velocity (Vm) and resistance index(RI) of middle cerebral artery were detected by color Doppler ultrasound before and after treatment for 10 ～ 14 days respectively. After birth for 3 ～ 5 days and 10 ～ 14 days,neonates with HIE were examined by imaging examinations. Results ①PSFV, EDFV and Vm of HIE patients were significantly lower than those in control group( P＜ 0.01 ). RI of HIE patients were significantly higher than those in control group(P＜0.05 ). After treatment for 10 ～ 14 days, PSFV, EDFV and Vm were obviously elevated in nimodipine group than routine group( P ＜0.01). RI weren't significantly differences in nimodipine group and routine group. The blood flow velocity of middle cerebral artery in nimodipine group got improvement than that in routine group, there was a significant differences between two groups(P ＜0. 01 ). ②After treatment for10 ～ 14 days,the computed tomography values were significant differences in nimodipine group than routine group in cortexes of frontal lobe( P＜0.01). Conclusion The cerebral hemodynamics in neonates with HIE is disorder apparently. It may be helpfulto evaluate the early diagnosis and prognosis of HIE and guide the clinical therapy of HIE using color Doppler ultrasound to monitor the hemodynamics indices. Nimodipine is effective in promoting and improving cerebral circulation and alleviate brain injury in neonates with HIE, the density of the brain parenchyma in neonates with HIE were significant recovery in cortexes of frontal lobe, indicating that nimodipine has a protective effect on hypoxic-ischemic damage in the neonate. Key words: Cerebral anoxia; Cerebral ischemia; Cerebral hemodynamics; Color Doppler ultrasound; Brain parenchyma density; Nimodipine; Infant; Newborn