振幅整合脑电图在预判新生儿高胆红素血症不良预后中的价值研究

The value of amplitude-integrated electroencephalogram to predicts long-term outcomes in term infant with severe hyperbilirubinemia

目的:探讨振幅整合脑电图(aEEG)在预判足月新生儿重度高胆红素血症不良预后的价值。方法:选取131例重度高胆红素血症患儿为研究对象。入院后予aEEG、脑干听觉诱发电位(BAEP)、颅脑磁共振成像(MRI)检查。所有患儿均予随访12个月。根据临床表现、aEEG、BAEP、头颅MRI结果及随访结果,分析aEEG在预判新生儿重度胆红素脑损伤不良预后的价值。结果:在131例入选患儿中26例被诊断患有急性胆红素脑病(ABE),其中5例婴儿预后不良。中重度异常aEEG对新生儿重度高胆红素血症不良预后的预测灵敏度为80.00%,特异性为87.07%,阳性预测值为21.05%,阴性预测值为99.02%。重度异常aEEG联合BAEP对新生儿重度高胆红素血症远期不良预后的预测灵敏度为100%,特异度为85.34%,阳性预测值为22.73%,阴性预测值为100%。结论:aEEG、aEEG联合BAEP可作为评估足月新生儿高胆红素血症不良预后的参考指标,具有十分重要的临床指导价值。

Objective To explore the value of amplitude-integrated electroencephalography(aEEG)in predicting the poor prognosis of severe hyperbilirubinemia in term newborns.Method A total of 131 children with severe hyperbilirubinemia were selected as subjects.All patients were enrolled in the aEEG、auditory brainstem response(BAEP)and magnetic resonance imaging(MRI)were performed.All patients were followed for 12 months.According to the clinical manifestations,aEEG,BAEP,head MRI results and follow-up results,the value of aEEG in predicting the prognosis of severe bilirubin in neonates was analyzed.Results Of the 131 patients enrolled,26 were diagnosed with acute bilirubin encephalopathy(ABE),and 5 of them had a poor prognosis.The predictive sensitivity of moderate to severe aEEG for poor prognosis of neonatal severe hyperbilirubinemia was 80.00%,specificity was 87.07%,positive predictive value was 21.05%,and negative predictive value was 99.02%.The predictive sensitivity of severe abnormal aEEG combined with auditory brainstem response for long-term poor prognosis of neonatal severe hyperbilirubinemia was 100%,specificity was 85.34%,positive predictive value was 22.73%,and negative predictive value was 100%.Conclusion aEEG and aEEG combined with BAEP can be used as a reference index to evaluate the poor prognosis of full-term neonatal hyperbilirubinemia,and it has important clinical guiding value.