目的：利用静息态功能磁共振（rs-fMRI）联合超声研究后扣带回与缺氧缺血性脑病（hypoxic ischemic encephalopathy，HIE）新生儿神经行为异常（neurobehavioral disorder，ND）的关系。方法：HIE新生儿 120例，根据新生儿行为神经测定（NBNA）评分结果分为非ND组（n=72）和ND组（n=48）。比较两组患儿 后扣带回超声灰度值以及rs-fMRI检查结果。Logistic回归分析HIE患儿ND的独立影响因素。多元线性 回归分析后扣带回ALFF值与脑网络全局属性参数的相关性。限制性立方样条法分析各指标与HIE患儿 ND的剂量反应关系。受试者特性工作特征（ROC）曲线分析患儿后扣带回超声灰度值与HIE程度及ND 的关系。结果：与非ND组比较，ND组出生5 min Apgar评分降低（P＜0.05），HIE分度显著增加（P＜0.05）； 后扣带回、苍白球、旁海马皮质ALFF值降低（P＜0.05）；网络强度（Sp）、局部效率（Eloc）、标准化最短路径 长度（λ）降低（P＜0.05）；后扣带回超声灰度值显著增加（P＜0.05）。Logistic回归分析结果显示，重度HIE 和较低水平的后扣带回ALFF值、Sp、Eloc、λ是HIE患儿ND的独立影响因素（P＜0.05）。多元线性回归分 析结果显示，后扣带回ALFF值与脑网络全局属性参数Sp、Eloc、λ正相关（β＞0，P＜0.05）。限制性立方样 条结果显示，后扣带回ALFF值、Sp、Eloc、λ与不同程度HIE患儿ND发生大致呈显著负相关。ROC曲线分 析结果显示，后扣带回超声灰度值对判断HIE程度具有较高的指导价值（AUC=0.871，P＜0.05），与ND发 生无明显关系（AUC=0.634，P＞0.05）。结论：HIE新生儿后扣带回ALFF值降低，功能连接异常，易发ND。

To investigate the relationship between the posterior cingulate gyrus and neurobehavioral disorders (ND) in neonates with hypoxic-ischemic encephalopathy (HIE) using resting-state functional magnetic resonance imaging (rs-fMRI) combined with ultrasound. Methods: A total of 120 neonates with HIE were enrolled and divided into a non-ND group (n=72) and an ND group (n=48) based on the results of the Neonatal Behavioral Neurological Assessment (NBNA) scores. The ultrasound gray-scale values of the posterior cingulate gyrus and the rs-fMRI findings were compared between the two groups. Logistic regression analysis was conducted to identify independent influencing factors for ND in neonates with HIE. Multiple linear regression analysis was performed to explore the correlation between the amplitude of low-frequency fluctuations (ALFF) values of the posterior cingulate gyrus and global network property parameters of the brain. The dose-response relationship between each indicator and ND in neonates with HIE was analyzed using the restricted cubic spline method. Receiver operating characteristic (ROC) curve analysis was utilized to assess the relationship between the ultrasound gray-scale values of the posterior cingulate gyrus, the severity of HIE, and ND. Results: Compared with the non-ND group, the ND group exhibited a lower 5-minute Apgar score at birth (P<0.05) and a significantly higher degree of HIE (P<0.05). The ALFF values of the posterior cingulate gyrus, globus pallidus, and parahippocampal cortex were decreased (P<0.05). Network strength (Sp), local efficiency (Eloc), and normalized shortest path length ( λ) were reduced (P<0.05). The ultrasound gray-scale values of the posterior cingulate gyrus were significantly increased (P<0.05). Logistic regression analysis revealed that severe HIE, as well as lower levels of ALFF values, Sp, Eloc, and λ in the posterior cingulate gyrus, were independent influencing factors for ND in neonates with HIE (P<0.05). Multiple linear regression analysis indicated a positive correlation between the ALFF values of the posterior cingulate gyrus and the global network property parameters Sp, Eloc, and λ (β >0, P<0.05). The restricted cubic spline analysis demonstrated a significant negative correlation between the ALFF values, Sp, Eloc, and λ of the posterior cingulate gyrus and the occurrence of ND in neonates with varying degrees of HIE. ROC curve analysis showed that the ultrasound gray-scale values of the posterior cingulate gyrus had high diagnostic value for assessing the severity of HIE (AUC=0.871, P<0.05) but no significant relationship with the occurrence of ND (AUC=0.634, P>0.05). Conclusion: Neonates with HIE exhibit decreased ALFF values and abnormal functional connectivity in the posterior cingulate gyrus, which are associated with an increased risk of ND.